Student Affairs, Baylor College of Medicine, Houston, TX, USA.
Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA.
Disabil Health J. 2023 Oct;16(4):101508. doi: 10.1016/j.dhjo.2023.101508. Epub 2023 Jul 16.
To better serve the growing population of individuals with spina bifida (SB) living into adulthood, pediatric SB clinics have developed structured health care transition (HCT) supports for adolescents and young adults. Evaluating the impact of structured HCT on SB-related chronic condition outcomes and transition planning goals is needed to assess such interventions.
This study explored the impact of a SB HCT Clinic on SB-related chronic condition management outcomes (e.g., reported bowel and bladder regimens and presence of pressure injury) and transition planning goals (e.g., decision-making, insurance, and transportation).
A retrospective chart review was conducted of young adults with SB who did and did not participate in an SB HCT Clinic before establishing an adult clinic to compare SB-condition outcomes and HCT planning goals between groups. Associations between demographic and clinical variables and outcomes were also assessed.
The HCT group (n = 68) was more likely to use a bowel regimen (P < 0.01) compared to the non-HCT group (n = 94). There were no differences regarding bladder regimens or incidence of pressure injuries. For HCT planning, the groups differed regarding decision-making supports (P = 0.01). Additionally, the HCT group was more likely to use self-transportation (P = 0.01) or Medicaid transportation (P < 0.01).
This single-center HCT program improved the use of a bowel regimen at the time of transfer to adult care and impacted HCT planning regarding decision-making and transportation. These initial findings support the need for further development and assessment of HCT programs for this population.
为了更好地服务于日益增多的成年脊柱裂（SB）患者，儿科 SB 诊所已经为青少年和年轻成人制定了结构化的健康护理过渡（HCT）支持。评估结构化 HCT 对 SB 相关慢性疾病结果和过渡计划目标的影响对于评估此类干预措施是必要的。
本研究探讨了 SB HCT 诊所对 SB 相关慢性疾病管理结果（例如，报告的肠道和膀胱方案以及压力性损伤的存在）和过渡计划目标（例如，决策、保险和交通）的影响。
对在建立成人诊所之前参加过 SB HCT 诊所和未参加过 SB HCT 诊所的年轻成人 SB 患者进行回顾性图表审查，以比较两组之间的 SB 疾病结果和 HCT 计划目标。还评估了人口统计学和临床变量与结果之间的关联。
HCT 组（n=68）比非 HCT 组（n=94）更有可能使用肠道方案（P<0.01）。两组之间在膀胱方案或压力性损伤的发生率方面没有差异。在 HCT 计划方面，两组在决策支持方面存在差异（P=0.01）。此外，HCT 组更有可能使用自行运输（P=0.01）或医疗补助运输（P<0.01）。
该单中心 HCT 计划在向成人护理转移时改善了肠道方案的使用，并对决策和交通方面的 HCT 计划产生了影响。这些初步发现支持进一步开发和评估该人群的 HCT 计划的必要性。
