title: Long-term effects of a multidisciplinary transition intervention from paediatric to adult care in patients with epilepsy.
abstract: OBJECTIVE
  To evaluate the long-term effects of a multidisciplinary transition intervention compared to the impact of patient-related intrinsic factors on the improvement in medical and psychosocial outcome.
  
  
  METHODS
  All patients who visited our multidisciplinary Epilepsy Transition Clinic between March 2012 and September 2014 were invited to participate (n=114). Patients were sent one questionnaire and informed consent was obtained. Questions included the patient's level of functioning on three transitional domains and a list with medical health care workers. Previously defined scores on three transitional domains and the risk profile score were re-evaluated. Past and current patient characteristics were compared using descriptive statistics. Discriminant analyses were used to determine the influence of patient-related intrinsic factors (defined as the risk factors from our previous study) and a multidisciplinary transition intervention on the improvement of medical and psychosocial outcome.
  
  
  RESULTS
  Sixty-six out of 114 invited participants (57.9%) completed the questionnaire. Discriminant analyses showed that the patient-related intrinsic factors combined proved a strong predictor for improvement in medical outcome (72.7%) and relatively strong for educational/vocational outcome (51.5%). The transition interventions are a relative strong predictor of improvement in medical outcome (56.1%), educational/vocational outcome (53.0%) and improvement in the overall risk score (54.5%).
  
  
  CONCLUSIONS
  Based on the overall improvement of psychosocial outcome in most patients, and the influence of a transition intervention on medical, educational/vocational outcome and the overall risk score, it is likely that adolescents with epilepsy benefit from visiting a multidisciplinary epilepsy transition clinic.
authors.affiliation: Epilepsy Center Kempenhaeghe, Heeze, The Netherlands. Electronic address: GeerlingsR@Kempenhaeghe.nl.
authors.forename: R P J
authors.initials: RP
authors.lastname: Geerlings
authors.affiliation: Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Faculty of Electrical Engineering, University of Technology, Eindhoven, The Netherlands; Department of Neurology, Maastricht University Hospital, The Netherlands; Department of Neurology, Ghent University Hospital, Belgium. Electronic address: AldenkampB@Kempenhaeghe.nl.
authors.forename: A P
authors.initials: AP
authors.lastname: Aldenkamp
authors.affiliation: Epilepsy Center Kempenhaeghe, Heeze, The Netherlands. Electronic address: GottmerL@Kempenhaeghe.nl.
authors.forename: L M C
authors.initials: LM
authors.lastname: Gottmer-Welschen
authors.affiliation: Institute of Health Policy & Management, Erasmus University Rotterdam, The Netherlands; Research Centre Innovations in Care, Rotterdam University of Applied Sciences, The Netherlands. Electronic address: a.van.staa@hr.nl.
authors.forename: A L
authors.initials: AL
authors.lastname: van Staa
authors.affiliation: Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Faculty of Electrical Engineering, University of Technology, Eindhoven, The Netherlands. Electronic address: LouwA@Kempenhaeghe.nl.
authors.forename: A J A
authors.initials: AJ
authors.lastname: de Louw
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D063868:Patient Outcome Assessment; D062606:Tertiary Care Centers / Q000592:standards / Q000706:statistics & numerical data*; D060305:Transition to Adult Care / Q000592:standards / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Epilepsy; Psychosocial outcome; Transition clinic; Transition intervention; Transition to adult care