PURPOSE: To evaluate the clinical changes of adults with cystic fibrosis (CF) during transition from a pediatric to adult CF center. METHODS: Data were collected at the time of transfer, 1 year earlier and 1 year later, for all patients in our adult CF center arriving from one of the three pediatric CF centers in Paris between January 2001 and June 2004. RESULTS: Sixty-three of the 68 patients (transferred at a median age of 21.0 years) were regularly attending this adult CF center after 1 year and one had died. The mean number of outpatient visits increased in the year after transfer (5.7 vs. 3.8 in the year before, p < .001). The occurrence of clinical events and the rate of bronchial colonization did not change. Pseudomonas aeruginosa was found in about 60% of patients at any time. Pulmonary function declined regularly with no statistically significant difference in the rate of decline between the 2 years of follow-up (FEV 1 was 54.7% predicted at transfer). Nutritional status remained stable (mean body mass index was 19.1 kg/m2). The number and duration of oral and i.v. antibiotic courses did not change, but more patients received them at home (p < .001) and self-administered physiotherapy after transfer (p = .001). The proportion of students decreased from 79.3% to 48.1% (p = .02) and the proportion in the workforce increased from 12.7% to 20.4% after transfer. CONCLUSIONS: Patients with CF remained clinically stable during transition and progressively acquired autonomy.
PURPOSE: To evaluate the clinical changes of adults with cystic fibrosis (CF) during transition from a pediatric to adult CF center. METHODS: Data were collected at the time of transfer, 1 year earlier and 1 year later, for all patients in our adult CF center arriving from one of the three pediatric CF centers in Paris between January 2001 and June 2004. RESULTS: Sixty-three of the 68 patients (transferred at a median age of 21.0 years) were regularly attending this adult CF center after 1 year and one had died. The mean number of outpatient visits increased in the year after transfer (5.7 vs. 3.8 in the year before, p < .001). The occurrence of clinical events and the rate of bronchial colonization did not change. Pseudomonas aeruginosa was found in about 60% of patients at any time. Pulmonary function declined regularly with no statistically significant difference in the rate of decline between the 2 years of follow-up (FEV 1 was 54.7% predicted at transfer). Nutritional status remained stable (mean body mass index was 19.1 kg/m2). The number and duration of oral and i.v. antibiotic courses did not change, but more patients received them at home (p < .001) and self-administered physiotherapy after transfer (p = .001). The proportion of students decreased from 79.3% to 48.1% (p = .02) and the proportion in the workforce increased from 12.7% to 20.4% after transfer. CONCLUSIONS:Patients with CF remained clinically stable during transition and progressively acquired autonomy.
Authors: Megumi J Okumura; Thida Ong; Diana Dawson; Dennis Nielson; Nancy Lewis; Martha Richards; Claire D Brindis; Mary Ellen Kleinhenz Journal: BMJ Qual Saf Date: 2014-01-10 Impact factor: 7.035
Authors: Christine W Paine; Natalie B Stollon; Matthew S Lucas; Lauren D Brumley; Erika S Poole; Tamara Peyton; Anne W Grant; Sophia Jan; Symme Trachtenberg; Miriam Zander; Petar Mamula; Christopher P Bonafide; Lisa A Schwartz Journal: Inflamm Bowel Dis Date: 2014-11 Impact factor: 5.325