Читать книгу Transition of Care - Группа авторов - Страница 7

Transition can be defined from physiological changes during the period from the end of puberty to the attainment of an adult phenotype. This gives the length of transition as approximately 5–10 years depending on the patient, although it may be longer or shorter depending on multiple factors. Alternatively, transition can be seen as the point in time when the patient can no longer be seen by the pediatrician and is asked to make the next appointment with an endocrinologist for adults. However, focusing on a single time point is not the best way to handle this process for a patient because the transition from pediatric care to the adult one needs to be structured. A large number of patients with chronic diseases drop out of therapy during the transition period. Multiple factors are associated with this, such as lack of understanding of the disease process, insufficient knowledge of treatment options, the patient becoming more independent, and the requirement for interaction with a new set of health care workers. Education regarding disease management and treatment options should be provided from an early age and through the transition period.

However, endocrine specialists will view the transition period differently, depending on whether they are pediatric endocrinologists, who mainly deal with congenital diseases in which auxology is important, or adult endocrinologists, who are more concerned with body composition and metabolic factors.

In this textbook, key leaders on different topics present their viewpoints as a pediatric and/or an adult endocrine specialist, most referring to a case study outlining practical aspects of transition. This textbook presents different approaches to patients with chronic diseases, either rare or not, during the transition period.

We definitely hope that this textbook will be helpful for the reader in front of a patient during the transition period and foster the development of specific health care pathways dedicated to the patient during this key period of life.

Philippe Touraine, Paris

Michel Polak, Paris