Original articleClinical Changes of Patients with Cystic Fibrosis during Transition from Pediatric to Adult Care
Section snippets
Patients
Seven CF centers in the Paris, France, area manage more than 1000 patients with CF: four are pediatric centers (Necker, Trousseau, and Robert Debré hospitals inside Paris, and André Mignot hospital in Versailles), one is a mixed pediatric and adult CF center (Créteil), and two are specifically adult CF centers (ours at Cochin hospital, Paris, and another one at Foch hospital, Suresnes). A retrospective survey was performed, including all patients arriving at our center from January 1, 2001 to
Demographic data
Sixty-eight patients were included in the present study. They came from one of the three pediatric CF centers in Paris (35 from Necker [51.5%], 19 from Trousseau [27.9%], and 14 from Robert Debré [20.6%]). Approximately 100 adults with CF had arrived at our CF center between January 1, 2001 and June 30, 2004.
Thirty-six of these 68 patients were women (52.9%) and 32 were men (47.1%). The mean age at diagnosis was 3.8 ± 5.2 years; the mean age at first arrival at the pediatric CF center in Paris
Discussion
Improvement in care of patients with CF has resulted in longer survival. A larger proportion of patients now reach adulthood. These patients require an age-appropriate care and counseling about adult issues, for example, independence acquisition, career choices, and reproduction. In the last 10 years, pediatric and adolescent health professionals have emphasized the need for developmentally appropriate health care and a smooth transition from pediatric care for young adults with chronic
Conclusion
Clinical status and care of young adults with CF did not change after transfer from a pediatric center to our adult CF center. There was no noticeable change in bacterial pulmonary colonization and in the main treatments. Nevertheless, they acquired autonomy in everyday life and in their disease management after transfer. These findings are likely the result of good transition policies and implementation within the various CF centers referred to. In addition to trying to improve survival,
Acknowledgments
We thank the physicians from the pediatric CF centers in Paris, A. Clément, B. Fauroux, J. Just (Hôpital Trousseau), A. Munck (Hôpital Robert Debré), G. Lenoir, J. de Blic, M. Sorin (Hôpital Necker), and from the Cochin adult CF center (D. Dusser, R. Kanaan, P.R. Burgel, and D. Manach) for their care of the patients.
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2019, Kendig's Disorders of the Respiratory Tract in ChildrenTransition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature
2017, International Journal of Nursing StudiesAn e-health intervention to support the transition of young people with long-term illnesses to adult healthcare services: Design and early use
2016, Patient Education and CounselingCitation Excerpt :This shifts the focus of transition from the negotiation of structural boundaries between services to the developmental needs of adolescents and young adults. A well planned transition appears to lead to improved adherence to appointments [15,16], improved patient satisfaction [17–19] and parent satisfaction [19], stable or improved disease control [20], improved relationships with health care professionals (HCPs) [21,22] and promotion of autonomy [21]. Inappropriate or inadequate transition is associated with poor clinic attendance [23], loss to follow-up, increased non-adherence to treatment, increased morbidities, increased emergency/hospital admissions [24] and adverse health outcomes [25–27].
This study was supported by Vaincre la Mucoviscidose.