Epilepsy: Transition from pediatric to adult care. Recommendations of the Ontario epilepsy implementation task force
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- Danielle M. Andrade
- Division of Neurology Epilepsy Transition Program and Epilepsy Genetics Program University of Toronto Toronto Western Hospital Toronto Ontario Canada
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- Anne S. Bassett
- Centre for Addiction and Mental Health University of Toronto Toronto Ontario Canada
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- Eduard Bercovici
- Division of Neurology University of Toronto Toronto Western Hospital Toronto Ontario Canada
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- Felippe Borlot
- Department of Neurology Clinical Neurosciences Center University of Utah School of Medicine Salt Lake City Utah U.S.A.
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- Esther Bui
- Division of Neurology University of Toronto Toronto Western Hospital Toronto Ontario Canada
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- Peter Camfield
- Division of Pediatric Neurology Dalhousie University Halifax Nova Scotia Canada
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- Guida Quaglia Clozza
- Parent Representative Toronto Ontario Canada
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- Eyal Cohen
- Division of Pediatric Medicine University of Toronto The Hospital for Sick Children Toronto Ontario Canada
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- Timothy Gofine
- Ontario Shores Whitby Ontario Canada
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- Lisa Graves
- Family Physician Sudbury Ontario Canada
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- Jon Greenaway
- Erin Oak Kids Centre for Treatment and Development Toronto Ontario Canada
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- Beverly Guttman
- Provincial Council for Maternal and Child Health Toronto Ontario Canada
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- Maya Guttman‐Slater
- Patient Representative Toronto Ontario Canada
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- Ayman Hassan
- Thunder Bay Regional Health Sciences Centre Thunder Bay Ontario Canada
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- Megan Henze
- Hospital for Sick Children Toronto Ontario Canada
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- Miriam Kaufman
- Division of Adolescent Medicine Department of Pediatrics University of Toronto The Hospital for Sick Children Toronto Ontario Canada
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- Bernard Lawless
- St. Michael's Hospital Toronto Ontario Canada
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- Hannah Lee
- Holland Bloorview Kids Rehabilitation Hospital Toronto Ontario Canada
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- Lezlee Lindzon
- Epilepsy Program Toronto Western Hospital Toronto Ontario Canada
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- Lysa Boissé Lomax
- Division of Neurology Queens University Kingston General Hospital Kingston Ontario Canada
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- Mary Pat McAndrews
- Division of Neuropsychology University of Toronto Toronto Western Hospital Toronto Ontario Canada
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- Dolly Menna‐Dack
- LIFEspan Service Holland Bloorview Kids Rehabilitation Hospital Toronto Ontario Canada
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- Berge A. Minassian
- Pediatric Epileptologist Division of Pediatric Neurology University of Toronto The Hospital for Sick Children Toronto Ontario Canada
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- Janice Mulligan
- Hospital for Sick Children Toronto Ontario Canada
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- Rima Nabbout
- Pediatric Neurologist Centre of Reference Epilepsies Rares Hospital Necker‐Enfants Malades Paris France
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- Tracy Nejm
- Parent Representative London Ontario Canada
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- Mary Secco
- Strategic Initiatives Epilepsy Support Centre London Ontario Canada
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- Laurene Sellers
- Family Physician Toronto Ontario Canada
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- Michelle Shapiro
- Division of Neurology McMaster University Hamilton Health Sciences Centre Hamilton Ontario Canada
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- Marie Slegr
- Neurologist Toronto Ontario Canada
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- Rosie Smith
- Adult Services Epilepsy Toronto Toronto Ontario Canada
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- Peter Szatmari
- Child and Youth Mental Health Collaborative Centre for Addiction and Mental Health Hospital for Sick Children University of Toronto Toronto Ontario Canada
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- Leeping Tao
- Surrey Place Centre Toronto Ontario Canada
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- Anastasia Vogt
- Critical Care Services Toronto Ontario Canada
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- Sharon Whiting
- Division of Pediatric Neurology University of Ottawa Children's Hospital of Eastern Ontario Ottawa Ontario Canada
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- O. Carter Snead
- Division of Pediatric Neurology University of Toronto The Hospital for Sick Children Toronto Ontario Canada
説明
<jats:title>Summary</jats:title><jats:p>The transition from a pediatric to adult health care system is challenging for many youths with epilepsy and their families. Recently, the Ministry of Health and Long‐Term Care of the Province of Ontario, Canada, created a transition working group (<jats:styled-content style="fixed-case">TWG</jats:styled-content>) to develop recommendations for the transition process for patients with epilepsy in the Province of Ontario. Herein we present an executive summary of this work. The <jats:styled-content style="fixed-case">TWG</jats:styled-content> was composed of a multidisciplinary group of pediatric and adult epileptologists, psychiatrists, and family doctors from academia and from the community; neurologists from the community; nurses and social workers from pediatric and adult epilepsy programs; adolescent medicine physician specialists; a team of physicians, nurses, and social workers dedicated to patients with complex care needs; a lawyer; an occupational therapist; representatives from community epilepsy agencies; patients with epilepsy; parents of patients with epilepsy and severe intellectual disability; and project managers. Three main areas were addressed: (1) Diagnosis and Management of Seizures; 2) Mental Health and Psychosocial Needs; and 3) Financial, Community, and Legal Supports. Although there are no systematic studies on the outcomes of transition programs, the impressions of the <jats:styled-content style="fixed-case">TWG</jats:styled-content> are as follows. Teenagers at risk of poor transition should be identified early. The care coordination between pediatric and adult neurologists and other specialists should begin before the actual transfer. The transition period is the ideal time to rethink the diagnosis and repeat diagnostic testing where indicated (particularly genetic testing, which now can uncover more etiologies than when patients were initially evaluated many years ago). Some screening tests should be repeated after the move to the adult system. The seven steps proposed herein may facilitate transition, thereby promoting uninterrupted and adequate care for youth with epilepsy leaving the pediatric system.</jats:p>
収録刊行物
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- Epilepsia
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Epilepsia 58 (9), 1502-1517, 2017-07-06
Wiley