title: Transition from Pediatric to Adult Specialty Care for Adolescents and Young Adults with Refractory Epilepsy: A Quality Improvement Approach.
abstract: Adolescents and young adults with refractory epilepsy are particularly vulnerable to serious medical and psychosocial challenges during transition from pediatric to adult care. Quality improvement methods were used to address the transition process on an academic medical campus. Outcomes achieved were decreased time from referral to first appointment in the adult clinic, H=8.2, p=0.004, r=0.43; and increased social work referrals using decision support, z=10.0, p=0.0006, OR=6.13. As measured by the 13-item Patient Activation Measure, pre-post change in patient activation as an outcome of self-management education was not statistically significant.
authors.affiliation: University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO. Electronic address: Jennifer.disabato@ucdenver.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Disabato
authors.affiliation: University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Cook
authors.affiliation: Department of Family Services, Children's Hospital Colorado, Aurora, CO.
authors.forename: Laura
authors.initials: L
authors.lastname: Hutton
authors.affiliation: Neurology Clinic, Children's Hospital Colorado, Aurora, CO.
authors.forename: Tristen
authors.initials: T
authors.lastname: Dinkel
authors.affiliation: Division of Child Neurology, University of Colorado School of Medicine, Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Levisohn
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration*; D061214:Patient Safety; D010372:Pediatrics / Q000379:methods; D058996:Quality Improvement; D018570:Risk Assessment; D012648:Self Care; D060305:Transition to Adult Care / Q000458:organization & administration*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Adolescents; Clinical decision support; Epilepsy; Self-management; Transition