Patterns of Healthcare Use and Medication Adherence among Youth with Systemic Lupus Erythematosus during Transfer from Pediatric to Adult Care
| العنوان: | Patterns of Healthcare Use and Medication Adherence among Youth with Systemic Lupus Erythematosus during Transfer from Pediatric to Adult Care |
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| المؤلفون: | Andrea M. Knight, Erica F. Lawson, Joyce C. Chang |
| المصدر: | J Rheumatol The Journal of rheumatology, vol 48, iss 1 |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Nephrology, Adult, medicine.medical_specialty, Transition to Adult Care, Adolescent, Clinical Sciences, Immunology, Lupus, Medication adherence, Adult care, patient compliance, Autoimmune Disease, Article, Medication Adherence, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Rheumatology, Clinical Research, 030225 pediatrics, Acute care, Internal medicine, Epidemiology, Health care, medicine, Ambulatory Care, longitudinal studies, Immunology and Allergy, Humans, Lupus Erythematosus, Systemic, pediatric systemic lupus erythematosus, Child, outcome assessment, Pediatric, 030203 arthritis & rheumatology, Lupus Erythematosus, business.industry, Systemic, Health Services, Arthritis & Rheumatology, Good Health and Well Being, Family medicine, Ambulatory, Public Health and Health Services, epidemiology, Patient Safety, business |
| الوصف: | Objective.Youth 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.Methods.We 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.Results.Of 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).Conclusion.Youth 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. |
| وصف الملف: | application/pdf |
| تدمد: | 0315-162X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dff6eab4c33d5c68bbf1a4afa195bf72Test https://pubmed.ncbi.nlm.nih.gov/33386347Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....dff6eab4c33d5c68bbf1a4afa195bf72 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 0315162X |
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