Çukurova University, Pediatric Metabolism and Nutrition Department, Adana, Turkey.
Çukurova University, Biostatistics Department, Adana, Turkey.
Arch Pediatr. 2023 Oct;30(7):450-454. doi: 10.1016/j.arcped.2023.04.006. Epub 2023 Jun 17.
In many countries, adult clinics specifically dedicated to adult patients with lysosomal storage diseases (LSDs) do not exist. In Turkey, these patients are managed either by pediatric metabolic specialists or adult physicians who do not specifically specialize in LSDs. In this study, we aimed to identify the unmet clinical needs of these adult patients and their suggestions.
The focus group participants were 24 adult LSD patients. Interviews were conducted in person.
A total of 23 LSD patients and parents of a patient with mucopolysaccharidosis type-3b with intellectual deficit were interviewed, with 84.6% of patients diagnosed after the age of 18 years and 18% of patients diagnosed before the age of 18 years desiring management by adult physicians. Patients with particular physical characteristics or severe intellectual deficit declined the transition. Patients reported structural problems in the hospital and social problems associated with pediatric clinics. They made suggestions to facilitate the possible transition.
With improved care, more patients with LSDs survive into adulthood or receive the diagnosis in adulthood. Children with chronic diseases need to transition to the care of adult physicians when they reach adulthood. Thus, there is an increasing need for adult physicians to manage these patients. In this study, most LSD patients accepted a well-planned and organized transition. Problems were related to stigmatization and social isolation in the pediatric clinic or adult issues with which pediatricians are not familiar. There is a need for adult metabolic physicians. Thus, health authorities should adopt necessary regulations for training of physicians in this field.
在许多国家,专门为成人生存贮池疾病 (LSD) 患者设立的成人诊所并不存在。在土耳其,这些患者由儿科代谢专家或不专门研究 LSD 的成人医生管理。在这项研究中,我们旨在确定这些成年患者的未满足的临床需求和他们的建议。
焦点小组参与者为 24 名成人生存贮池疾病患者。访谈是亲自进行的。
共访谈了 23 名 LSD 患者和 1 名患有黏多糖贮积症 3b 型伴智力缺陷的患者的父母,其中 84.6%的患者在 18 岁后确诊,18%的患者在 18 岁前确诊,希望由成人医生管理。具有特殊身体特征或严重智力缺陷的患者拒绝过渡。患者报告了医院的结构问题和与儿科诊所相关的社会问题。他们提出了一些建议,以促进可能的过渡。
随着医疗护理的改善,越来越多的 LSD 患者存活到成年或在成年时被诊断出该疾病。患有慢性疾病的儿童在成年后需要过渡到成人医生的护理。因此,成人医生管理这些患者的需求日益增加。在这项研究中,大多数 LSD 患者接受了精心规划和组织的过渡。问题与儿科诊所的污名化和社会隔离或儿科医生不熟悉的成人问题有关。需要成人代谢医生。因此,卫生当局应采取必要的规定,培训该领域的医生。