Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 93
Filtrar
1.
J Pediatr Gastroenterol Nutr ; 79(3): 550-557, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39090984

RESUMO

OBJECTIVES: Pathology is an essential component of disease diagnosis and management in pediatric gastroenterology. Pathology reports have not been standardized in some areas of pediatric gastrointestinal pathology and pathology reporting varies. Development of electronic medical record (EMR) pathology synoptic report templates (PSRT) enables pathology data collection in a specific format and can help standardize pathology reporting. We developed, implemented, and evaluated EMR PSRTs for eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD). METHODS: PSRTs were developed by a multidisciplinary team of pediatric experts of allergy, gastroenterology, and pathology for both EoE and IBD based on available literature and validated scales. Likert surveys (range 1 low acceptance to 5 high acceptance) based on the Technology Acceptance Model assessed user acceptance of the developed PSRTs. The use of PSRTs was monitored via control charts. RESULTS: Overall, evaluation questionnaires achieved >80% response rates. Clinicians and pathologists reported moderate-to-high levels of Perceived Usefulness (median (interquartile range) for EoE PSRT: clinicians 4.0 (4.0, 5.0) and pathologists 3.5 (3.5, 4.0); and IBD PSRT: clinicians 4.0 (3.0, 4.0) and pathologists 4.0 (4.0, 5.0)) and Perceived Ease of Use (EoE PSRT: clinicians 4.5 (4.0, 5.0) and pathologists 4.0 (4.0, 4.0); and IBD PSRT: clinicians 4.0 (4.0, 5.0) and pathologists 4.0 (4.0, 5.0)) of the developed PSRTs. Control charts demonstrated 100% utilization by 2-5 months from launch. CONCLUSIONS: We demonstrate successful implementation of synoptic reporting for both pediatric EoE and IBD pathology. EMR synoptic reporting provides standardization of pathology reporting and improved methods of pathology data presentation, which could potentially optimize provider efficiency, clinician interpretation of pathology results and disease trajectory, patient care, and clinician satisfaction.


Assuntos
Registros Eletrônicos de Saúde , Esofagite Eosinofílica , Doenças Inflamatórias Intestinais , Humanos , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/patologia , Doenças Inflamatórias Intestinais/patologia , Doenças Inflamatórias Intestinais/diagnóstico , Criança , Inquéritos e Questionários , Gastroenterologia/normas , Gastroenterologia/métodos , Pediatria/normas , Pediatria/métodos
2.
J Pediatr ; 275: 114244, 2024 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-39151602

RESUMO

OBJECTIVE: To evaluate the status of health insurance knowledge and self-efficacy among adolescents and young adults with inflammatory bowel disease (AYA-IBD). STUDY DESIGN: English-proficient AYA-IBD ≥15 years receiving care at an academic pediatric practice were invited to perform the Kaiser Family Foundation survey on health information knowledge and the Health Insurance Literacy Measure. Analyses of responses by demographic factors were performed using nonparametric analyses and agreement analyses were performed to compare survey responses. RESULTS: Fifty AYA-IBD (60% 15-17 years old; 54% male; 76% White; 32% Hispanic) completed the surveys. Most AYA-IBD (58%) answered less than half the health insurance knowledge questions correctly. Reported ability and confidence in choosing and using health insurance was slight to moderate (median 2.8 on Likert scale of 1 [not at all confident] to 4 [very confident]). While health insurance knowledge scores did not vary by demographic factors, total health insurance self-efficacy increased with disease duration, and Hispanic participants reported reduced ability to select health insurance than non-Hispanic counterparts. CONCLUSIONS: AYA-IBD demonstrated suboptimal health insurance knowledge and self-efficacy. Our findings identify an important opportunity to provide health insurance education to help prepare all AYA-IBD to manage the costs of medical care during the transition process to adulthood.

3.
J Pediatr Gastroenterol Nutr ; 79(3): 558-563, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39034484

RESUMO

In the United States, clinical work had been primarily compensated via a relative value unit (RVU) system reliant on professional surveys estimating the value of clinical care events. However, with the advent of time-based billing in 2021, time accounting has become an important work compensation metric. The Signal functionality within Epic, the most widely used electronic medical record (EMR) system in North America, tracks clinician time within the system. We extracted Epic Signal data from 10,200 gastroenterologists at 356 North American institutions for analysis. Workload metrics were reported as group median (interquartile range) per month and comparisons were performed using nonparametric testing. Gastroenterologists exhibit different EMR time patterns based on clientele and practice arenas. Compared with counterparts, pediatric and academic gastroenterologists spend more time at each encounter which had not been compensated under prior RVU valuations. Clinical compensation benchmarks should be driven by time-based workload metrics to ensure appropriate compensation.


Assuntos
Registros Eletrônicos de Saúde , Gastroenterologistas , Carga de Trabalho , Carga de Trabalho/estatística & dados numéricos , Humanos , Registros Eletrônicos de Saúde/estatística & dados numéricos , América do Norte , Gastroenterologistas/estatística & dados numéricos , Gastroenterologia/estatística & dados numéricos , Gastroenterologia/organização & administração , Escalas de Valor Relativo , Estados Unidos , Benchmarking
4.
Appl Clin Inform ; 15(3): 437-445, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38839064

RESUMO

BACKGROUND: Clinical informatics (CI) has reshaped how medical information is shared, evaluated, and utilized in health care delivery. The widespread integration of electronic health records (EHRs) mandates proficiency among physicians and practitioners, yet medical trainees face a scarcity of opportunities for CI education. OBJECTIVES: We developed a CI rotation at a tertiary pediatric care center to teach categorical pediatric, pediatric-neurology, and medicine-pediatric residents foundational CI knowledge and applicable EHR skills. METHODS: Created in 2017 and redesigned in 2020, a CI rotation aimed to provide foundational CI knowledge, promote longitudinal learning, and encourage real-world application of CI skills/tools. Led by a team of five physician informaticist faculty, the curriculum offers personalized rotation schedules and individual sessions with faculty for each trainee. Trainees were tasked with completing an informatics project, knowledge assessment, and self-efficacy perception survey before and after rotation. Paired t-test analyses were used to compare pre- and postcurriculum perception survey. RESULTS: Thirty-one residents have completed the elective with their projects contributing to diverse areas such as medical education, division-specific initiatives, documentation improvement, regulatory compliance, and operating plan goals. The mean knowledge assessment percentage score increased from 77% (11.6) to 92% (10.6; p ≤ 0.05). Residents' perception surveys demonstrated improved understanding and confidence across various informatics concepts and tools (p ≤ 0.05). CONCLUSION: Medical trainees are increasingly interested in CI education and find it valuable. Our medical education curriculum was successful at increasing residents' understanding, self-efficacy, and confidence in utilizing CI concepts and EHR tools. Future data are needed to assess the impact such curricula have on graduates' proficiency and efficiency in the use of CI tools in the clinical workplace.


Assuntos
Currículo , Informática Médica , Pediatria , Informática Médica/educação , Humanos , Pediatria/educação , Pessoal de Saúde/educação , Registros Eletrônicos de Saúde , Internato e Residência
6.
JAMA Netw Open ; 7(3): e243133, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38512254

RESUMO

Importance: Young children are ingesting illicit drugs at increased rates, but it is unknown what the associated child protection system (CPS) responses are when a child tests positive. Objective: To document the child protection system involvement and the characteristics of children who test positive for illicit substances. Design, Setting, and Participants: This retrospective cross-sectional study linked medical discharge and child protection system administrative data. The setting was Rady Children's Hospital San Diego, a free-standing pediatric hospital in California. Participants included all emergency department and inpatient medical encounters involving children aged 12 years or younger with a positive urine drug test between 2016 and 2021. Statistical analysis was performed from February 2023 to January 2024. Exposure: Drug type, including amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, fentanyl, opiates, and phencyclidine. Main Measures and Outcomes: CPS responses associated with the medical encounter including reports, substantiations, case openings, and out-of-home placements. Results: A total of 511 emergency department and inpatient medical encounters involving children had a positive drug test (262 [51.3%] were female; 309 [60.5%] were age 6 years or younger; fewer than 10 [<3.0%] were American Indian or Alaska Native; 252 [49.3%] were Hispanic [any race], 20 [3.9%] were non-Hispanic Asian, 56 [11.0%] were non-Hispanic Black, 143 [28.0%] were non-Hispanic White, 36 [7.0%] had other or unknown race and ethnicity; 233 [43.6%] had a CPS report prior to the medical encounter). Following the positive screen, 244 (47.7%) were reported to child protection, and 61 (11.9%) were placed out-of-home within 30 days. Mean (SD) quarterly counts of encounters with positive drug tests doubled after the COVID-19 pandemic onset (32.9 [9.8]) compared with prior to the pandemic onset (16.5 [4.7]); for encounters positive for cannabis, mean (SD) quarterly counts were 3 times as high after the pandemic onset than prior (16.6 [4.7] vs 5.7 [2.9]). Encounters for children under age 1 were significantly more likely to have associated child protection reports (relative risk [RR], 2.91 [95% CI, 2.21-3.83]) and child protection case openings (RR, 1.71 [95% CI, 1.07-2.72]) than encounters involving older children. Conclusions and Relevance: In this cross-sectional study of emergency department and inpatient medical encounters, less than half of children with positive urine drug screens were reported to CPS; out-of-home placements were uncommon. With increased encounters for positive drug tests, it is unclear what services these children and families are receiving.


Assuntos
Cannabis , Alucinógenos , Criança , Humanos , Feminino , Adolescente , Pré-Escolar , Masculino , Estudos Transversais , Pandemias , Estudos Retrospectivos , Urina , Urinálise , Agonistas de Receptores de Canabinoides
7.
Expert Rev Gastroenterol Hepatol ; 18(1-3): 89-102, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38465446

RESUMO

INTRODUCTION: Strategies to promote high-quality endoscopy in children require consensus around pediatric-specific quality standards and indicators. Using a rigorous guideline development process, the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN) was developed to support continuous quality improvement efforts within and across pediatric endoscopy services. AREAS COVERED: This review presents a framework, informed by the PEnQuIN guidelines, for assessing endoscopist competence, granting procedural privileges, audit and feedback, and for skill remediation, when required. As is critical for promoting quality, PEnQuIN indicators can be benchmarked at the individual endoscopist, endoscopy facility, and endoscopy community levels. Furthermore, efforts to incorporate technologies, including electronic medical records and artificial intelligence, into endoscopic quality improvement processes can aid in creation of large-scale networks to facilitate comparison and standardization of quality indicator reporting across sites. EXPERT OPINION: PEnQuIN quality standards and indicators provide a framework for continuous quality improvement in pediatric endoscopy, benefiting individual endoscopists, endoscopy facilities, and the broader endoscopy community. Routine and reliable measurement of data, facilitated by technology, is required to identify and drive improvements in care. Engaging all stakeholders in endoscopy quality improvement processes is crucial to enhancing patient outcomes and establishing best practices for safe, efficient, and effective pediatric endoscopic care.


Assuntos
Inteligência Artificial , Indicadores de Qualidade em Assistência à Saúde , Humanos , Criança , Endoscopia Gastrointestinal/efeitos adversos , Melhoria de Qualidade , Consenso
9.
Acad Pediatr ; 24(1): 87-91, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37247840

RESUMO

OBJECTIVE: To evaluate whether maltreatment investigated during infancy affects high-acuity health care utilization patterns during early childhood. METHODS: Retrospective case-control study based on linked data between child protection and hospital encounter records conducted to review health records of infants investigated for abuse and/or neglect. Cases and controls were followed longitudinally through the Rady Children's Hospital electronic health records for 4 years starting at the age of 1 year. RESULTS: A total of 3692 children were investigated for maltreatment within the first year of life. When comparisons were made between children reported for maltreatment and matched controls, children with infancy maltreatment reports had significantly more high-acuity health care encounters than matched controls (average treatment effect = 1.53, 95% Confidence Interval 1.08-1.99, P < .001). CONCLUSIONS: Infants investigated for maltreatment have greater high-acuity health care utilization in early childhood. These findings highlight this population's need for well-defined medical homes to ensure appropriate health care. Further understanding of the underlying reasons for this increased health care burden will help inform these efforts.


Assuntos
Maus-Tratos Infantis , Lactente , Criança , Humanos , Pré-Escolar , Estudos Longitudinais , Estudos Retrospectivos , Estudos de Casos e Controles , Maus-Tratos Infantis/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde
10.
Child Abuse Negl ; 146: 106450, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37708644

RESUMO

BACKGROUND: Mechanisms for reporting child maltreatment (CM) were affected by changes in service provision immediately following the onset of the COVID-19 pandemic. OBJECTIVE: To examine changes in counts and CPS reporting of CM medical encounters before and after the onset of COVID-19. PARTICIPANTS AND SETTING: All emergency department and inpatient medical encounters with at least one CM diagnosis during the study period at Rady Children's Hospital San Diego, the largest pediatric hospital in California between 2016 and November 2021. METHODS: Using linked medical record and CPS administrative data, interrupted time series models tested for changes in monthly counts and percentages of CM medical encounters reported to CPS with the onset of COVID-19. Logistic regression tested for the likelihood of a CPS report being associated with a CM encounter. RESULTS: CM medical encounters totaled 2528, including 793 after the onset of COVID-19. Interrupted time series models indicated with the onset of the pandemic, the counts of CM encounters increased 18 % (RR: 1.18, 95 % CI 1.03-1.34) and the percentages reported to CPS increased 10 % (RR: 1.10, 95 % CI: 1.05-1.17). CM encounters that occurred after the onset of the COVID-19 pandemic had increased odds of a CPS report (fully adjusted model: OR: 1.08; 95 % CI: 1.05-1.12). CONCLUSIONS: This study found increases in monthly counts and a higher percentage of CM medical encounters with CPS reports after the pandemic onset.


Assuntos
COVID-19 , Maus-Tratos Infantis , Criança , Humanos , Pandemias , COVID-19/epidemiologia , Maus-Tratos Infantis/diagnóstico , Proteção da Criança , Notificação de Abuso , Serviço Hospitalar de Emergência
12.
J Pediatr Gastroenterol Nutr ; 77(3): 422-425, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37364063

RESUMO

In 2022, the Pediatric Endoscopy Quality Improvement Network published quality metrics related to pediatric endoscopy. We utilized electronic medical record (EMR) tools to collect pediatric endoscopy quality metrics (PEQM) and to standardize proceduralist feedback. EMR tools were created to capture and display PEQM: (1) an endoscopy documentation template, (2) nursing documentation of events during endoscopy for timed calculations, and (3) a data dashboard. Dashboard metrics provided individualized PEQM feedback relative to group performance and ideals where available. Utilization of the endoscopy documentation tools and data dashboard was measured. Utility was assessed using a survey based on the Technology Adoption Model. Adoption of documentation tools has been nearly universal with positive survey outcomes. Robust dashboard visualization has been demonstrated. Use of EMR documentation tools standardized PEQM collection. Future capture and sharing of common PEQM data across institutions could help determine PEQM benchmarks.


Assuntos
Benchmarking , Registros Eletrônicos de Saúde , Humanos , Criança , Retroalimentação , Endoscopia Gastrointestinal , Inquéritos e Questionários , Melhoria de Qualidade
13.
J Pediatr Gastroenterol Nutr ; 77(1): 121-125, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37326849

RESUMO

Chronic hepatitis B viral (HBV) infection is associated with significant morbidity and mortality with endemic areas carrying most of the global burden of HBV disease. Current HBV screening rates in the United States are suboptimal. We aimed to improve HBV screening rates at regional family health centers serving high-risk refugee populations by 20% over 2 years. We used quality improvement (QI) methodology and implemented interventions providing electronic medical record (EMR)-enabled HBV screening tools within known clinical workflows. EMR tools captured country-of-origin data to identify persons from HBV-endemic regions with provision of a laboratory order set to ensure performance of appropriate HBV screening tests. The project was initiated prior to the COVID pandemic but continued during the pandemic with imposed social isolation measures. We nevertheless demonstrated 4 statistical process control chart shifts and achieved our QI smart aim. Further, we demonstrated a high HBV detection rate (8.2%-12.8%) among persons identified for screening.


Assuntos
COVID-19 , Hepatite B Crônica , Hepatite B , Humanos , Estados Unidos/epidemiologia , Registros Eletrônicos de Saúde , Saúde da Família , Melhoria de Qualidade , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/prevenção & controle , Programas de Rastreamento , Hepatite B/epidemiologia
14.
J Pediatr ; 262: 113582, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37353150

RESUMO

OBJECTIVE: To assess the counts of infant maltreatment-related medical encounters at a large medical system during a 21-month span of the COVID-19 pandemic. METHODS: Retrospective data for this study came from all inpatient and emergency department medical encounters for infants from January 1, 2016, through November 30, 2021, at a single children's hospital system in California. Distributions of medical encounters were tabulated and plotted over time. Interrupted time series models were used to evaluate changes in child maltreatment medical encounters. RESULTS: Medical encounters for infants with child maltreatment diagnoses increased following the onset of COVID-19. Monthly counts of encounters with indicated maltreatment trended upward following the start of the pandemic. Interrupted time series models showed that the count of maltreatment encounters increased 64% with the onset of COVID-19. CONCLUSIONS: We found an increase in infant maltreatment medical encounters during a 21-month period following the onset of COVID-19. These findings suggest that the pandemic may have adversely affected the safety of infants and ongoing work is needed to understand better the pandemic impacts on child maltreatment.


Assuntos
COVID-19 , Maus-Tratos Infantis , Criança , Lactente , Humanos , Estudos Retrospectivos , Pacientes Internados , Pandemias , COVID-19/epidemiologia , Maus-Tratos Infantis/diagnóstico , Serviço Hospitalar de Emergência
15.
JAMA Netw Open ; 6(4): e239549, 2023 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-37083660

RESUMO

Importance: Information about the trend in illicit substance ingestions among young children during the pandemic is limited. Objectives: To assess immediate and sustained changes in overall illicit substance ingestion rates among children younger than 6 years before and during the COVID-19 pandemic and to examine changes by substance type (amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids) while controlling for differing statewide medicinal and recreational cannabis legalization policies. Design, Setting, and Participants: Retrospective cross-sectional study using an interrupted time series at 46 tertiary care children's hospitals within the Pediatric Health Information System (PHIS). Participants were children younger than 6 years who presented to a PHIS hospital for an illicit substance(s) ingestion between January 1, 2017, and December 31, 2021. Data were analyzed in February 2023. Exposure: Absence or presence of the COVID-19 pandemic. Main Outcome(s) and Measure(s): The primary outcome was the monthly rate of encounters for illicit substance ingestions among children younger than 6 years defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code(s) for poisoning by amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids. The secondary outcomes were the monthly rate of encounters for individual substances. Results: Among 7659 children presenting with ingestions, the mean (SD) age was 2.2 (1.3) years and 5825 (76.0%) were Medicaid insured/self-pay. There was a 25.6% (95% CI, 13.2%-39.4%) immediate increase in overall ingestions at the onset of the pandemic compared with the prepandemic period, which was attributed to cannabis, opioid, and ethanol ingestions. There was a 1.8% (95% CI, 1.1%-2.4%) sustained monthly relative increase compared with prepandemic trends in overall ingestions which was due to opioids. There was no association between medicinal or recreational cannabis legalization and the rate of cannabis ingestion encounters. Conclusions and Relevance: In this study of illicit substance ingestions in young children before and during the COVID-19 pandemic, there was an immediate and sustained increase in illicit substance ingestions during the pandemic. Additional studies are needed to contextualize these findings in the setting of pandemic-related stress and to identify interventions to prevent ingestions in face of such stress, such as improved parental mental health and substance treatment services, accessible childcare, and increased substance storage education.


Assuntos
COVID-19 , Cannabis , Cocaína , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos , Humanos , Criança , Pré-Escolar , Pandemias , Estudos Retrospectivos , Estudos Transversais , COVID-19/epidemiologia , Anfetaminas , Analgésicos Opioides , Etanol , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ingestão de Alimentos
16.
Gastrointest Endosc Clin N Am ; 33(2): 267-290, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36948746

RESUMO

Quality indicators and standards for pediatric endoscopy have recently been developed by the inaugural working group of the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN). Currently available electronic medical record (EMR) functionalities can enable real-time capture of quality indicators to support continuous quality measurement and improvement within pediatric endoscopy facilities. Ultimately, EMR interoperability and cross-institutional data sharing can serve to validate PEnQuIN standards of care and permit benchmarking across endoscopy services, in the pursuit of elevating the quality of endoscopic care for children everywhere.


Assuntos
Registros Eletrônicos de Saúde , Endoscopia Gastrointestinal , Humanos , Criança , Melhoria de Qualidade
18.
J Pediatr Gastroenterol Nutr ; 76(3): 325-330, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36729665

RESUMO

OBJECTIVE: Determination of transitional readiness is an essential component of delivery of transition services to adolescents and young adults with chronic diseases, including those with inflammatory bowel disease (IBD). To date, this has been performed using the transition checklist (TC). However, clinical experience suggests the validity of the checklist may not be ideal. We sought to evaluate the validity of the TC among adolescents and young adults with IBD (AYA IBD). METHODS: We evaluated the validity of the TC compared with a skills-based practicum (TKSP) in a cross-sectional study using a real-world clinical cohort of AYA IBD. Extent of concordance between TC and TKSP was assessed using confusion matrices and calculation of Matthews correlation coefficients. RESULTS: Concordance between self-reported TC answers and TKSP performance varied based on skill/knowledge base assessed, ranging from 81.3% for mastery of knowing one's medical condition to 39.2% for mastery of knowing one's medication schedule and 29.3% for mastery of knowing how to refill medications. Matthews correlation coefficients were closer to random prediction than perfect correlation for all skills/knowledge tested. CONCLUSIONS: Self-reported TC answers lack sufficient concordance with TKSP performance. Our findings suggest that a TKSP should be performed to assess for transition readiness and to identify individual AYA IBD patient needs during the transition process.


Assuntos
Doenças Inflamatórias Intestinais , Transição para Assistência do Adulto , Adolescente , Adulto Jovem , Humanos , Autorrelato , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Doenças Inflamatórias Intestinais/diagnóstico
19.
J Autism Dev Disord ; 53(4): 1476-1482, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35217944

RESUMO

Limited guidance is available for families of youth with ASD (YASD) to prepare for invasive medical procedures. This study examined caregiver perspectives regarding YASD's gastrointestinal endoscopy (GE) experience to improve the endoscopy experience for YASD. Thirty-four caregivers of YASD, (M = 9.85 years, SD = 4.6) who underwent GE at Rady Children's Hospital, San Diego between May 2018 and July 2019 (identified via electronic health record) participated in a structured phone interview. Caregivers reported a positive experience due to the procedural team's responsiveness to the needs of YASD and appropriately answering/addressing questions/concerns. Caregivers reported a need for ASD-specific information on how to prepare for GE. Specific recommendations are discussed. Study findings offer strategies to improve the care experience of YASD undergoing GE.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Criança , Humanos , Adolescente , Cuidadores , Transtorno do Espectro Autista/terapia , Endoscopia Gastrointestinal
20.
Transl Sci Rare Dis ; 6(1-2): 13-23, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35892038

RESUMO

Eosinophilic gastrointestinal disorders (EGID) are a group of allergen-mediated conditions which are characterized by eosinophilic inflammation affecting one or more parts of the gastrointestinal tract. A disproportionately higher number of EGID patients are diagnosed in the pediatric age group. Given the chronic course of EGIDs and lack of curative therapies at this time, majority of the pediatric EGID patients may require continued care well into their adulthood. However, to date, scant data are available regarding the health care transition (HCT), the transition of care (TC), and the effectiveness of transfer of care EGID patients from pediatric-oriented to adult-oriented providers. Herein, we review the lessons learnt from transfer of care of children with other chronic gastrointestinal and allergic conditions, analyze the current knowledge, potential barriers, the role of various stakeholders in successful transfer of care of EGID patients, propose a conceptual framework for HCT and TC of EGID patients, and identify outcome measures to ensure the quality of progression of care.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA