Systematic review and critical appraisal of transitional care programmes in rheumatology

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• 作者：Daniel Clemente ; MD^a ; Leticia Leon ; MS ; PhD^b ; ^{lleon.hcsc@salud.madrid.org} ; Helen Foster ; MD ; PhD^c ; Kirsten Minden ; MD ; PhD^d ; Loreto Carmona ; MD ; PhD^e
• 关键词：RMD ; rheumatic and musculoskeletal diseases ; jRMDs ; juvenile onset rheumatic and musculoskeletal diseases ; JIA ; juvenile idiopathic arthritis ; MAGICC ; moving on in adolescence ; growing up in collaboration and coping ; DON&rsquo ; T RETARD ; devices for the OptimisatioN of TRansfEr and transition of adolescents with rheumatic disorders ; YARD ; young adult with rheumatic diseases ; BTP ; Berlin transition programme ; PReS ; paediatric rheumatology european society ; EULAR ; European league against rheumatism
• 刊名：Seminars in Arthritis and Rheumatism
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：46
• 期：3
• 页码：372-379
• 全文大小：825 K
• 卷排序：46

文摘

Identify existing models of transitional care in rheumatic and musculoskeletal diseases (RMD), describe their strengths and weaknesses, and provide support to a consensus initiative to develop recommendations for transitional care.MethodsA systematic review was conducted to identify publications describing transition programmes in RMD. Eligibility for inclusion required detailed description of the programme. Descriptive information was collected, including country of the programme, target diseases and ages of the patients, resources, elements of the transition process and, when described, outcomes and quality indicators. Quality assessment of the programmes included: level of definition and the evidence base for the programme, availability of quality indicators and evidence of effectiveness.ResultsOverall, 27 articles were identified and evaluated, related to 8 programmes in 6 countries: 4 covered all RMDs, 3 specific for patients with juvenile idiopathic arthritis (JIA) and 1 programme generic for chronic diseases and adapted for RMD. Core elements of these transition programmes included the following: a written transition policy; patient individualised planning and flexibility of transitional care; designation of transition coordinator role; acquisition of knowledge and skills in self-management of care; decision making, shared care and communication between paediatric and adult health care provider teams and a planned transfer to adult rheumatology. Only 2 provided evidence of effectiveness according to previously specified outcome measures.ConclusionsTransitional care programmes in RMDs are variable in their structures, staffing and processes. There are no standardised measures of outcome or effectiveness. This information provides important valuable insights and strategies to develop transitional care in RMD.