保健服务没有为有长期健康状况的年轻人从儿童转到成人服务提供足够的支持。国家卫生与保健研究所(NICE)已经发布了过渡指南,以解决这些差距。然而,关于可能需要过渡的年轻人数量的数据通常很少。以注意力缺陷多动障碍(ADHD)为例,这项研究使用了现有的监测系统和案例说明审查来捕获过渡过程的发生率,并对调查结果进行了比较和对比。
儿童和青少年精神病学监测系统(CAPSS)用于估计患有注意力缺陷多动障碍(ADHD)的年轻人从儿童服务到成人服务的事件过渡。这涉及来自英国(UK)和爱尔兰共和国(ROI)的顾问儿童和青少年精神科医生报告在诊所看到的相关年轻人。并行,我们使用Maudsley生物医学研究中心(BRC)临床记录交互式检索(CRIS)进行了病例记录审查.研究期持续12个月,随访9个月,看看过渡是如何进行的。
CRIS在研究期间确定了76例,与通过CAPSS监测确定的18例相比。使用这两种方法都遇到了方法学问题。监控问题;资格标准混淆,报告错误,不完整的问卷,联系临床医生的困难,和监测系统不涵盖非顾问的非医生和精神科医生。使用CRIS的案例注释审查问题包括研究人员需要解释临床注释,注释中数据的可用性和完整性,和数据仅限于一个特定的心理健康信托基金的集水区。
两种方法都显示出优点和缺点;在没有强大的常规收集数据的情况下,两种方法的组合,允许对服务规划和调试的需求水平进行更可靠的估计。
Health services have not provided adequate support for young people with long term health conditions to transfer from child to adult services. National Institute of Health and Care (NICE) guidance on transition has been issued to address these gaps. However, data are often sparse about the number of young adults who might need to transition. Using Attention Deficit Hyperactivity Disorder (ADHD) as an exemplar, this study used an existing surveillance system and a
case note review to capture the incidence of the transition process, and compared and contrasted the findings.
The Child and Adolescent Psychiatry Surveillance System (CAPSS) was used to estimate the incident transition of young people with Attention Deficit Hyperactivity Disorder (ADHD) from child to adult services. This involves consultant child and adolescent psychiatrists from the United Kingdom (UK) and Republic of Ireland (ROI) reporting relevant young people as they are seen in clinics. In parallel, a
case note review was conducted using the Maudsley Biomedical Research Centre (BRC) Clinical Records Interactive Search (CRIS). The study period ran for twelve months with a nine month follow up to see how the transition proceeded.
CRIS identified 76 cases in the study period, compared to 18 identified using surveillance via CAPSS. Methodological issues were experienced using both methods. Surveillance issues; eligibility criteria confusion, reporting errors, incomplete questionnaires, difficulties contacting clinicians, and surveillance systems do not cover non-doctors and psychiatrists who are not consultants.
Case note review issues using CRIS included the need for researchers to interpret clinical notes, the availability and completeness of data in the notes, and data limited to the catchment of one particular mental health trust.
Both methods demonstrate strengths and weaknesses; the combination of both methods in the absence of strong routinely collected data, allowed a more robust estimate of the level of need for service planning and commissioning.