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Careful transition for young people with epilepsy
For young people with chronic disease, transition from paediatric to adult services requires careful planning. This is not always achieved smoothly. Hargreaves DS et al. [Lancet Child and Adol 2019;3(9):627–635.VoP627-635, https://doi.org/10.1016/S2352-4642(19)30201-9] report a longitudinal data linkage study examining the association between quality of paediatric care, hospital admissions, and all-cause deaths among epilepsy patients. They examined the paediatric epilepsy services in England, linking unit-level data from round 1 (2009–11) and round 2 (2013–14) of the Epilepsy12 national clinical audit, with death registrations from the UK Office for National Statistics and data for unplanned hospital admissions from Hospital Episode Statistics. There were ninety nine units with data for the analyses relating to paediatricians with epilepsy expertise and epilepsy specialist nurses. They examined the association between unit-level performance in involving a paediatrician with epilepsy expertise, an epilepsy specialist nurse, and a paediatric neurologist (where appropriate) in round one and the proportion of adolescents (aged 10–18 years) with epilepsy admitted to each unit who subsequently died during the study period (April 1, 2009, to March 31, 2015). The mortality rate in the study was 134 (7%) of 1795 patients whom died during the study period; 88 (5%) died after the …
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