Transition between child and adult services for young people with attention-deficit hyperactivity disorder (ADHD): findings from a British national surveillance study.
Transition between child and adult services for young people with attention-deficit hyperactivity disorder (ADHD): findings from a British national surveillance study.
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患有注意力缺陷多动症障碍（ADHD）的儿童和成人服务之间的过渡：来自英国国家监视研究的发现。
DOI：
10.1192/bjp.2019.131
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Janssens A
中科院分区：
文献类型：
--
作者：
Eke H;Ford T;Newlove-Delgado T;Price A;Young S;Ani C;Sayal K;Lynn RM;Paul M;Janssens A
从儿童服务向成人服务的最佳过渡涉及连续性、共同护理、规划会议和信息传递;因此，专员和服务提供者需要关于有多少人需要这种服务的数据。虽然注意力缺陷多动障碍（ADHD）经常持续到成年，但这些转变的证据有限。估计全国年轻人服用药物治疗ADHD需要和完成过渡的发生率，并描述经历最佳过渡的比例。使用英国儿科监测单位和儿童和青少年精神病学监测系统进行12个月以上的监测，包括基线通知和随访问卷。基线时问卷回答率为79%，随访时为82%。对于17-19岁的人来说，每年每10万17-19岁的人中有202-511人有过渡需要的发生率（调整无反应的范围），每年每10万17-19岁的人中有38-96人成功过渡。符合条件的ADHD年轻人大多为男性（77%），伴有合并症（62%）。其中一半被转介到成人ADHD专科，25%被转介到一般成人心理健康服务; 64%的人接受了转介，但只有22%的人参加了第一次预约。只有6%符合最佳过渡标准。由于入选标准要求受试者接受药物治疗，因此这些估计值代表了过渡需求的下限。显然有两个关键点：接受转诊和首次预约就诊。成功过渡率低，遵守准则的情况有限，这表明委员和服务提供者非常需要改善服务过渡体验。
Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions. To estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition. Surveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires. Questionnaire response was 79% at baseline and 82% at follow-up. For those aged 17–19, incident rate (range adjusted for non-response) of transition need was 202–511 per 100 000 people aged 17–19 per year, with successful transition of 38–96 per 100 000 people aged 17–19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria. As inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences.
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