Strangers Headed to a Strange Land? A Pilot Study of Using a Transition Coordinator to Improve Transfer from Pediatric to Adult Services
Strangers Headed to a Strange Land? A Pilot Study of Using a Transition Coordinator to Improve Transfer from Pediatric to Adult Services
复制标题
DOI：
10.1016/j.jpeds.2013.07.031
复制
发表时间：
2013-12-01
影响因子：
5.1
通讯作者：
Kerkar, Nanda
中科院分区：
文献类型：
--
作者：
Annunziato, Rachel A.;Baisley, Margaret C.;Kerkar, Nanda
目的比较过渡协调人对儿科肝移植受者预后的影响，并与历史对照组进行比较。研究设计采用他克莫司血药浓度(Tacrolimus SD，SDS)测量方法，比较过渡协调人组(20例2007-2012年间转院的20例肝移植受者)和对照组在转院前后1年的服药依从性，以检验过渡协调人的有效性。对过渡协调组进行健康管理、生活质量和可接受性测量。结果采用重复测量方差分析比较过渡协调组与对照组的依从性。在转移前一年，对于过渡协调组，对照组患者的他克莫司标准差为1.98(SD=1.05)比3.25(SD=1.19)，F(1，25)=4.77，P=0.04。转移后，过渡协调组的水平保持稳定，他克莫司SD=1.88(SD=1.57)，但对对照组患者，他克莫司SD=4.36(SD=0.99)，F(1，25)=6.99，P=0.01。结论我们的研究结果虽然受到小样本数量的限制，但表明过渡协调员是改善这一过程的一种有前途的方法。
Objective To compare the impact of a transition coordinator on outcomes for pediatric liver transplant recipients vs a historical comparison group.Study design To examine the utility of a transition coordinator, medication adherence, as measured by SDs of tacrolimus blood levels (Tacrolimus SD), was compared between the "transition coordinator group" (20 transplant recipients transferred between 2007 and 2012) and comparison group for 1 year before and after transfer. Measures of health care management, quality of life, and acceptability were administered to the transition coordinator group as well.Results A repeated measures ANOVA was used to compare adherence values between the transition coordinator group and the comparison group. During the year before transfer, for the transition coordinator group, Tacrolimus SD was 1.98 (SD=1.05) vs 3.25 (SD=1.19) for comparison patients, F(1,25)=4.77, P=.04. After transfer, levels remained stable for the transition coordinator group, Tacrolimus SD=1.88 (SD=1.57), but increased for comparison patients, Tacrolimus SD=4.36 (SD=0.99), F(1,25)=6.99, P=.01. Psychosocial outcomes remained stable during the transfer period and acceptability was high.Conclusions Our findings, although limited by a small sample size, suggest that a transition coordinator is a promising method to improve this process.