Transitional Care in Anorectal Malformation & Hirschsprung's Disease | 234 Studies Identified | Systematic Review UK & Malaysia | 3 Challenges | 3 Solutions | CHALLENGES | Patient's lack of understanding of their condition | Lack of education about pediatric colorectal conditions among adult surgeons | Lack of transition programs | SOLUTIONS | Foster young adult patient's autonomy | Conduct joint pediatric-adult transition clinics | Create a structured and coordinated transition program | Conclusion: A framework for addressing barriers and solutions in pediatric colorectal transition helps set care quality standards. | https://www.jpedsurg.org/article/S0022-3468(23)00075-1/fulltext | Source: Plascevic J et al. | Paediatric Surgery, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, United Kingdom | @StayCurrentMD | @gigenace | Cincinnati Children's | Journal of Pediatric Surgery
Transitional Care in Anorectal Malformation and Hirschsprung's Disease
Infographic · Aug 2024 · 1 min read
In brief
In brief
Systematic review identifying key barriers to transitioning ARM and HD patients from pediatric to adult care, including patient knowledge gaps, lack of adult surgeon expertise, and absence of structured programs. Proposes solutions including joint transition clinics, standardized guidelines, and fostering patient autonomy to improve care continuity.
- Patients with ARM/HD often lack understanding of their condition, leading to over-reliance on pediatric teams and resistance to adult care.
- Adult colorectal surgeons frequently lack training in pediatric colorectal conditions, creating care gaps during transition.
- Joint pediatric-adult transition clinics with standardized protocols improve continuity of care for ARM and HD patients.
- Fostering patient autonomy and independence before transition reduces reliance on pediatric surgical teams.
- Structured transition programs using standardized guidelines are essential but currently lacking for ARM and HD populations.
Written by the GCMD Library team from the infographic.
The infographic uses a teal header, light blue body, and yellow footer. The left side highlights three challenges in red text, while the right side presents three corresponding solutions in purple text. Icons include a brain with connections, a magnifying glass over a document, and institutional logos at the bottom.
New infographic from the Journal of pediatric Surgery by Dr. Cecilia Gigena
"Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions"
Authors: Josip Plascevic, Shaneel Shah, Yew-Wei Tan
Full article: https://gcmd.co/3WHxvKX
Background
The literature on transitional care in anorectal malformation (ARM) and Hirschsprung's disease (HD) is diverse and heterogeneous. There is a lack of standards and guidelines specific to transitional care in these conditions. We aim to establish and systematically categorize challenges and solutions related to colorectal transition care.
Methods
Systematic review of qualitative studies from MEDLINE, EMBASE, PubMed and Scopus databases (2008–2022) was conducted to identify the challenges and solutions of healthcare transition specific to ARM and HD. Thematic analyses are reported with reference to patient, healthcare provider and healthcare system.
Results
Sixteen studies from 234 unique articles were included. Fourteen themes related to challenges and solutions, each, are identified. Most challenges identified are patient related. The key challenges pertain to: (1) patient's lack of understanding of their disorder, resulting in over-reliance on the pediatric surgical team and reluctance towards transitioning to adult services; (2) a lack of education and awareness among adult colorectal surgeons in caring for pediatric colorectal conditions and inadequate communication between pediatric and adult teams; and (3) a lack of structured transition program and joint-clinic to meet the needs of the transitioning patients. The key solutions are: (1) fostering young adult patient's autonomy and independence; (2) conducting joint pediatric-adult transition clinics; and (3) ensuring a structured and coordinated transition program is available using a standardized guideline.
Conclusion
A comprehensive framework related to barriers and solutions for pediatric colorectal transition is established to help benchmark care quality of transitional care services.