ABSTRACT
Antecedentes y objetivo: El proceso de transición de la asistencia pediátrica a la adulta es un tema de gran interés en los últimos años, especialmente en enfermedades crónicas de inicio en la infancia, como los errores congénitos del metabolismo (ECM). Los avances en el diagnóstico y el tratamiento de estas enfermedades han mejorado su pronóstico, encontrando en la actualidad un elevado número de pacientes con ECM que alcanzan la edad adulta y necesitan ser atendidos por profesionales no pediátricos. El objetivo de este trabajo es establecer unas pautas de actuación para que los especialistas involucrados garanticen una transición exitosa de la atención sanitaria de estos pacientes. Metodología: Tras realizar una revisión bibliográfica del tema, los autores, partiendo de su propia experiencia, elaboraron un documento inicial que fue sometido a sucesivos debates hasta obtener el documento definitivo. En caso de discrepancia de criterio, la recomendación de consenso se decidió por mayoría. Resultados: Se presentan una serie de recomendaciones para el mejor abordaje clínico de la transición asistencial de los pacientes con ECM desde el entorno pediátrico a la asistencia de adultos, con el objetivo de conseguir los mejores resultados en este proceso, dadas las características especiales de este subgrupo de pacientes, así como las principales dificultades que conlleva el proceso de transición Conclusiones: Se resalta el papel del médico internista en este proceso de transición y su correcta articulación con el entorno pediátrico y social. Asimismo, se recomiendan acciones y actitudes para mejorar la calidad de dicha transición (AU)
Background and objective: The transition process from paediatric to adult care is a subject of great interest in recent years, especially in chronic diseases with childhood onset, such as inborn errors of metabolism (IEM). Advances in diagnosis and treatment of these diseases have improved their prognosis, with a high number of patients with IEM who currently reach adult age and need to be attended to by non-paediatric professionals. The objective of this work is to establish action guidelines so that the specialists involved can guarantee a successful transition of these patients healthcare. Methodology: After carrying out a bibliographic review of the subject, the authors, beginning with their own experience, produced an initial document which was subjected to successive debates until the final document was obtained. The consensus recommendation was decided by the majority in case of criterion discrepancy. Results: A series of recommendations are presented for the best clinical management of the transitions of care of patients with IEM from the paediatric to adult care setting in order to achieve the best results in this process given the special characteristics of this patient subgroup and the main difficulties entailed in the transition process. Conclusions: The role of the internal medicine doctor in this transition process and correct interrelation with the paediatric and social setting is stressed. Furthermore, actions and attitudes are suggested to improve the quality of said transition (AU)
Subject(s)
Humans , Adolescent , Adult , Metabolism, Inborn Errors/therapy , Patient Care Planning/organization & administration , Transitional Care/organization & administration , Practice Patterns, Physicians' , Risk Factors , Adolescent Behavior , Adolescent Health Services/organization & administrationABSTRACT
BACKGROUND AND OBJECTIVE: The transition process from paediatric to adult care is a subject of great interest in recent years, especially in chronic diseases with childhood onset, such as inborn errors of metabolism (IEM). Advances in diagnosis and treatment of these diseases have improved their prognosis, with a high number of patients with IEM who currently reach adult age and need to be attended to by non-paediatric professionals. The objective of this work is to establish action guidelines so that the specialists involved can guarantee a successful transition of these patients' healthcare. METHODOLOGY: After carrying out a bibliographic review of the subject, the authors, beginning with their own experience, produced an initial document which was subjected to successive debates until the final document was obtained. The consensus recommendation was decided by the majority in case of criterion discrepancy. RESULTS: A series of recommendations are presented for the best clinical management of the transitions of care of patients with IEM from the paediatric to adult care setting in order to achieve the best results in this process given the special characteristics of this patient subgroup and the main difficulties entailed in the transition process. CONCLUSIONS: The role of the internal medicine doctor in this transition process and correct interrelation with the paediatric and social setting is stressed. Furthermore, actions and attitudes are suggested to improve the quality of said transition.
