scholarly journals Estimation of age of transition from children's to adult healthcare for young people with long term conditions using linked routinely collected healthcare data

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Stuart William Jarvis ◽  
Gerry Richardson ◽  
Kate Flemming ◽  
Lorna Fraser
Keyword(s):  
Young People ◽  
Transition Point ◽  
Long Term Conditions ◽  
Transition Age ◽  
Healthcare Data ◽  
Misclassification Bias ◽  
Healthcare Transition ◽  
Reduce Risk ◽  
Nationally Representative

IntroductionHealthcare transitions, including from paediatric to adult services, can be disruptive and cause a lack of continuity in care. Existing research on the paediatric-adult healthcare transition often uses a simple age cut-off to assign transition status. This risks misclassification bias, reducing observed changes at transition (adults are included in the paediatric group and vice versa) possibly to differing extents between groups that transition at different ages. ObjectiveTo develop and assess methods for estimating the transition point from paediatric to adult healthcare from routine healthcare records. MethodsA retrospective cohort of young people (12 to 23 years) with long term conditions was constructed from linked primary and secondary care data in England. Inpatient and outpatient records were classified as paediatric or adult based on treatment and clinician specialities. Transition point was estimated using three methods based on record classification (First Adult: the date of first adult record; Last Paediatric: date of last paediatric record; Fitted: a date determined by statistical fitting). Estimated transition age was compared between methods. A simulation explored impacts of estimation approaches compared to a simple age cut-off when assessing associations between transition status and healthcare events. ResultsSimulations showed using an age-based cut-off at 16 or 18 years as transition point, common in research on transition, may underestimate transition-associated changes. Many health records for those aged 14 years were classified as adult, limiting utility of the First Adult approach. The Last Paediatric approach is least sensitive to this possible misclassification and may best reflect experience of the transition. ConclusionsEstimating transition point from routine healthcare data is possible and offers advantages over a simple age cut-off. These methods, adapted as necessary for data from other countries, should be used to reduce risk of misclassification bias in studies of transition in nationally representative data.

scholarly journals M.I.C.E—Mental Health Intervention for Children with Epilepsy: a randomised controlled, multi-centre clinical trial evaluating the clinical and cost-effectiveness of MATCH-ADTC in addition to usual care compared to usual care alone for children and young people with common mental health disorders and epilepsy—study protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sophie D. Bennett ◽  
◽  
J. Helen Cross ◽  
Anna E. Coughtrey ◽  
Isobel Heyman ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Usual Care ◽  
Psychological Intervention ◽  
Mental Health Disorders ◽  
Long Term Conditions ◽  
Children And Young People ◽  
Health Disorders ◽  
Randomised Controlled

Abstract Background Mental health disorders in the context of long-term conditions in children and young people are currently overlooked and undertreated. Evidence-based psychological treatments for common childhood mental health disorders (anxiety, depression and disruptive behaviour disorders) have not been systematically evaluated in young people with epilepsy despite their high prevalence in this population. The aim of this multi-site randomised controlled trial is to determine the clinical and cost-effectiveness of adding a modular psychological intervention to usual care for the mental health disorders in comparison to assessment-enhanced usual care alone. Methods In total, 334 participants aged 3–18 years attending epilepsy services will be screened for mental health disorders with the Strengths and Difficulties Questionnaire (SDQ) and the diagnostic Development and Wellbeing Assessment (DAWBA). Those identified as having a mental health disorder and consenting to the trial will be randomised to either receive up to 22 sessions of the modular psychological intervention (MATCH-ADTC) delivered over the telephone over 6 months by non-mental health professionals in addition to usual care or to assessment-enhanced usual care alone. Outcomes will be measured at baseline, 6 months and 12 months post-randomisation. It is hypothesised that MATCH-ADTC plus usual care will be superior to assessment-enhanced usual care in improving emotional and behavioural symptoms. The primary outcome is the SDQ reported by parents at 6 months. Secondary outcomes include parent-reported mental health measures such as the Revised Children’s Anxiety and Depression Scale, quality of life measures such as the Paediatric Quality of Life Inventory and physical health measures such as the Hague Seizure Severity Scale. Outcome assessors will be blinded to group assignment. Qualitative process evaluations and a health economic evaluation will also be completed. Discussion This trial aims to determine whether a systematic and integrated approach to the identification and treatment of mental health disorders in children and young people with epilepsy is clinically and cost-effective. The findings will contribute to policies and practice with regard to addressing mental health needs in children and young people with other long-term conditions. Trial registration ISRCTN ISRCTN57823197. Registered on 25 February 2019.

scholarly journals From informed consent to dissemination: Using participatory visual methods with young people with long-term conditions at different stages of research

2016 ◽  
Vol 11 (5-6) ◽  
pp. 636-650 ◽  
Author(s):  
Cecilia Vindrola-Padros ◽  
Ana Martins ◽  
Imelda Coyne ◽  
Gemma Bryan ◽  
Faith Gibson
Keyword(s):  
Informed Consent ◽  
Young People ◽  
Visual Methods ◽  
Long Term Conditions

scholarly journals How well do services for young people with long term conditions deliver features proposed to improve transition?

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
A. Colver ◽  
◽  
R. Pearse ◽  
R. M. Watson ◽  
M. Fay ◽  
...  
Keyword(s):  
Young People ◽  
Long Term Conditions

Young people and developmentally appropriate transitional care in rheumatology

2013 ◽  
pp. 11-21
Author(s):  
Janet E. McDonagh ◽  
Helena Gleeson
Keyword(s):  
Young People ◽  
Transitional Care ◽  
Developmentally Appropriate ◽  
Adolescent And Young Adult ◽  
Adolescent Medicine ◽  
Psychosocial Needs ◽  
Long Term Conditions ◽  
Health And Illness ◽  
Youth Friendly

Young people are distinctly different from children and adults and as such require developmentally appropriate, youth-friendly rheumatology services to meet their medical and psychosocial needs. Adolescent development continues into the third decade of life and both influences and is affected by, health and illness (including) during this time. Effective transitional care in rheumatology is underpinned by the core principles of adolescent medicine, self-management of long-term conditions, and a developmentally appropriate, youth-friendly rheumatology service including staff trained in adolescent and young adult (AYA) health.

scholarly journals Community pharmacy advanced adherence services for children and young people with long-term conditions: A cross-sectional survey study

2020 ◽  
Vol 18 (1) ◽  
pp. 1720
Author(s):  
Zahra Alsairafi ◽  
Julie Mason ◽  
Natasha Davies ◽  
Molly Dennis ◽  
Gabrielle Pilgrim ◽  
...  
Keyword(s):  
Young People ◽  
Community Pharmacy ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Children And Young People

scholarly journals What makes for a ‘good’ or ‘bad’ paediatric diabetes service from the viewpoint of children, young people, carers and clinicians? A synthesis of qualitative findings

2015 ◽  
Vol 100 (9) ◽  
pp. 826-833 ◽  
Author(s):  
Katherine Curtis-Tyler ◽  
Lisa Arai ◽  
Terence Stephenson ◽  
Helen Roberts
Keyword(s):  
Young People ◽  
Physical Health ◽  
Age Groups ◽  
Long Term Conditions ◽  
Children And Young People ◽  
Paediatric Diabetes ◽  
Experience Of Care ◽  
Crucial Part ◽  
Selection Of

BackgroundThere is mounting evidence that experience of care is a crucial part of the pathway for successful management of long-term conditions.Design and objectivesTo carry out (1) a systematic mapping of qualitative evidence to inform selection of studies for the second stage of the review; and (2) a narrative synthesis addressing the question, What makes for a ‘good’ or a ‘bad’ paediatric diabetes service from the viewpoint of children, young people, carers and clinicians?ResultsThe initial mapping identified 38 papers. From these, the findings of 20 diabetes-focused papers on the views on care of ≥650 children, parents and clinicians were synthesised. Only five studies included children under 11 years. Children and young people across all age groups valued positive, non-judgemental and relationship-based care that engaged with their social, as well as physical, health. Parents valued provision responsive to the circumstances of family life and coordinated across services. Clinicians wanting to engage with families beyond a child's immediate physical health described finding this hard to achieve in practice.LimitationsSocioeconomic status and ethnicity were poorly reported in the included studies.ConclusionsIn dealing with diabetes, and engaging with social health in a way valued by children, parents and clinicians, not only structural change, such as more time for consultation, but new skills for reworking relations in the consultation may be required.

scholarly journals Benefits and Costs of Digital Consulting in Clinics Serving Young People With Long-Term Conditions: Mixed-Methods Approach

2018 ◽  
Vol 6 (4) ◽  
pp. e48 ◽  
Author(s):  
Sung Wook Kim ◽  
Jason Madan ◽  
Melina Dritsaki ◽  
Carol Bryce ◽  
Vera Forjaz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Young People ◽  
Long Term Conditions ◽  
Mixed Methods Approach ◽  
Benefits And Costs

scholarly journals Benefits and Costs of Digital Consulting in Clinics Serving Young People With Long-Term Conditions: Mixed-Methods Approach (Preprint)

2018 ◽  
Author(s):  
Sung Wook Kim ◽  
Jason Madan ◽  
Melina Dritsaki ◽  
Carol Bryce ◽  
Vera Forjaz ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Young People ◽  
Health Professionals ◽  
Direct Costs ◽  
Long Term Conditions ◽  
Team Members ◽  
The United Kingdom ◽  
Part Model

BACKGROUND Since the introduction of digital health technologies in National Health Service (NHS), health professionals are starting to use email, text, and other digital methods to consult with their patients in a timely manner. There is lack of evidence regarding the economic impact of digital consulting in the United Kingdom (UK) NHS. OBJECTIVE This study aimed to estimate the direct costs associated with digital consulting as an adjunct to routine care at 18 clinics serving young people aged 16-24 years with long-term conditions. METHODS This study uses both quantitative and qualitative approaches. Semistructured interviews were conducted with 173 clinical team members on the impacts of digital consulting. A structured questionnaire was developed and used for 115 health professionals across 12 health conditions at 18 sites in the United Kingdom to collect data on time and other resources used for digital consulting. A follow-up semistructured interview was conducted with a single senior clinician at each site to clarify the mechanisms through which digital consulting use might lead to outcomes relevant to economic evaluation. We used the two-part model to see the association between the time spent on digital consulting and the job role of staff, type of clinic, and the average length of the working hours using digital consulting. RESULTS When estimated using the two-part model, consultants spent less time on digital consulting compared with nurses (95.48 minutes; P<.001), physiotherapists (55.3 minutes; P<.001), and psychologists (31.67 minutes; P<.001). Part-time staff spent less time using digital consulting than full-time staff despite insignificant result (P=.15). Time spent on digital consulting differed across sites, and no clear pattern in using digital consulting was found. Health professionals qualitatively identified the following 4 potential economic impacts for the NHS: decreasing adverse events, improving patient well-being, decreasing wait lists, and staff workload. We did not find evidence to suggest that the clinical condition was associated with digital consulting use. CONCLUSIONS Nurses and physiotherapists were the greatest users of digital consulting. Teams appear to use an efficient triage system with the most expensive members digitally consulting less than lower-paid team members. Staff report showed concerns regarding time spent digitally consulting, which implies that direct costs increase. There remain considerable gaps in evidence related to cost-effectiveness of digital consulting, but this study has highlighted important cost-related outcomes for assessment in future cost-effectiveness trials of digital consulting.

Sign in / Sign up

Export Citation Format

Share Document