التفاصيل البيبلوغرافية
| العنوان: |
Patterns of Healthcare Use and Medication Adherence among Youth with Systemic Lupus Erythematosus during Transfer from Pediatric to Adult Care |
| المؤلفون: |
Chang, Joyce C, Knight, Andrea M, Lawson, Erica F |
| المصدر: |
The Journal of Rheumatology, vol 48, iss 1 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2021 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Paediatrics, Biomedical and Clinical Sciences, Patient Safety, Autoimmune Disease, Pediatric, Clinical Research, Health Services, Lupus, Good Health and Well Being, Adolescent, Adult, Ambulatory Care, Child, Humans, Lupus Erythematosus, Systemic, Medication Adherence, Rheumatology, Transition to Adult Care, Young Adult, pediatric systemic lupus erythematosus, longitudinal studies, outcome assessment, patient compliance, epidemiology, Clinical Sciences, Immunology, Public Health and Health Services, Arthritis & Rheumatology |
| جغرافية الموضوع: |
105 - 113 |
| الوصف: |
ObjectiveYouth with systemic lupus erythematosus (SLE) transferring from pediatric to adult care are at risk for poor outcomes. We describe patterns of rheumatology/nephrology care and changes in healthcare use and medication adherence during transfer.MethodsWe identified youth ages 15-25 with SLE using US private insurance claims from Optum's deidentified Clinformatics Data Mart. Rheumatology/nephrology visit patterns were categorized as (1) unilateral transfers to adult care within 12 months, (2) overlapping pediatric and adult visits, (3) lost to followup, or (4) continuing pediatric care. We used negative binomial regression and paired t tests to estimate changes in healthcare use and medication possession ratios (MPR) after the last pediatric (index) visit. We compared MPR between youth who transferred and age-matched peers continuing pediatric care.ResultsOf the 184 youth transferred out of pediatric care, 41.8% transferred unilaterally, 31.5% had overlapping visits over a median of 12 months before final transfer, and 26.6% were lost to followup. We matched 107 youth continuing pediatric care. Overall, ambulatory care use decreased among those lost to followup. Acute care use decreased across all groups. MPR after the index date were lower in youth lost to followup (mean 0.24) compared to peers in pediatric care (mean 0.57, p < 0.001).ConclusionYouth with SLE with continuous private insurance coverage do not use more acute care after transfer to adult care. However, a substantial proportion fail to see adult subspecialists within 12 months and have worse medication adherence, placing them at higher risk for adverse outcomes. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt4zd8s8jn; https://escholarship.org/uc/item/4zd8s8jnTest |
| الإتاحة: |
https://escholarship.org/uc/item/4zd8s8jnTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.FB77E22 |
| قاعدة البيانات: |
BASE |
