AB1000 EFFECT OF THE LIPAT KALINGA ADOLESCENT TRANSITION CLINIC ON FILIPINO ADOLESCENTS WITH RHEUMATIC DISEASES
Authors: J. Rapacon, L. Dans
Journal: Annals of the Rheumatic Diseases (2020)

Background: Establishing a transition program is important in bridging the gap between pediatric and adult healthcare especially in patients with chronic diseases. The Division of Pediatric Rheumatology of the Philippine General Hospital (PGH) established the Lipat Kalinga Adolescent Transition Clinic (LKATC) to help in the transfer from pediatric to adult healthcare by providing the support and guidance needed through education and reinforcement of self-management skills. This study is an assessment of the effect of the LKATC on the transition readiness of Filipino adolescents with rheumatic diseases at the PGH. Objectives: To assess the effect of the LKATC program on Filipino adolescent patients with rheumatic diseases Methods: This is a mixed-method study design done at the Philippine General Hospital. A retrospective descriptive before and after study was conducted along with a focus group discussion (FGD). The participants were pediatric rheumatology patients enrolled at the LKATC from May,2018 to April,2019. Comparison of the pre and post University of North Carolina (UNC) TRxANSITION scale (Filipino version) overall score and domains was done and facilitation of an FGD to elicit barriers and facilitating factors for the effective implementation of the LKATC. The FGD used a predefined discussion guide based on literature review and was done by a trained facilitator. Results: We evaluated a total of 17 adolescent patients with rheumatologic diseases. Comparing the pre-intervention and post-intervention test scores, statistically significant increases were noted in several domains. Health transitional skills of these adolescents were noted to improve in terms of total score, medication, nutrition, self-management, informed reproduction, trade and school issues, insurance issues, and new health providers. There was no significant improvement in the type of illness, adherence and ongoing support. Four patients who were enrolled at the LKATC and who attended at least 5 sessions participated in the FGD. The barrier themes elicited were 1. Expectation and beliefs regarding adult healthcare, 2. Different doctor-patient relationship, 3. Logistical problems. The facilitating themes elicited were 1. Familiarization, 2. Peer support, 3. Communication. Conclusion: This study showed the effects of an adolescent transition clinic program in Filipino adolescent with rheumatic disease. Significant increase in the overall UNC TRxANSITION score as well as majority of the scores per domains were seen. Barriers and facilitating factors affecting the transition process elicited during a focus group discussion were also presented. This study provided baseline data on the importance of establishing an adolescent transition clinic for patients with chronic disease in the local setting. References: [1]Foster, H. et al. EULAR/PReS standards and recommendations for the transitional care of young people with juvenile-onset rheumatic diseases. Ann Rheum Dis 2016;0:1-8. [2]Alfiler, CA, Llanto, EA et al. Adolescent Pediatric Kidney Patients Transitioned to Adult Health Care Services through the Philippine General Hospital Transition Program. Acta Medica Philipina Vol 46 No. 4 2012-Vol 47 No. 1 2013 Disclosure of Interests: None declared