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Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions

Background: The literature on transitional care in anorectal malformation (ARM) and Hirschsprung's disease (HD) is diverse and heterogeneous. There is a lack of standards and guidelines speci fic to transitional care in these conditions. We aim to establish and systematically categorize challen...

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Main Authors: Plascevic, Josip, Shah, Shaneel, Tan, Yew Wei
Format: Article
Published: Elsevier 2024
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R Medicine
Online Access:http://eprints.um.edu.my/45197/
https://doi.org/10.1016/j.jpedsurg.2023.10.066
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spelling my.um.eprints.451972024-09-26T01:43:56Z http://eprints.um.edu.my/45197/ Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions Plascevic, Josip Shah, Shaneel Tan, Yew Wei R Medicine Background: The literature on transitional care in anorectal malformation (ARM) and Hirschsprung's disease (HD) is diverse and heterogeneous. There is a lack of standards and guidelines speci fic to transitional care in these conditions. We aim to establish and systematically categorize challenges and solutions related to colorectal transition care. Methods: Systematic review of qualitative studies from MEDLINE, EMBASE, PubMed and Scopus databases (2008-2022) was conducted to identify the challenges and solutions of healthcare transition speci fic to ARM and HD. Thematic analyses are reported with reference to patient, healthcare provider and healthcare system. Results: Sixteen studies from 234 unique articles were included. Fourteen themes related to challenges and solutions, each, are identi fied. Most challenges identi fied are patient related. The key challenges pertain to: (1) patient's lack of understanding of their disorder, resulting in over -reliance on the pediatric surgical team and reluctance towards transitioning to adult services; (2) a lack of education and awareness among adult colorectal surgeons in caring for pediatric colorectal conditions and inadequate communication between pediatric and adult teams; and (3) a lack of structured transition program and joint -clinic to meet the needs of the transitioning patients. The key solutions are: (1) fostering young adult patient's autonomy and independence; (2) conducting joint pediatric -adult transition clinics; and (3) ensuring a structured and coordinated transition program is available using a standardized guideline. Conclusion: A comprehensive framework related to barriers and solutions for pediatric colorectal transition is established to help benchmark care quality of transitional care services. Level of Evidence: IV. Type of Study: Systematic review without meta -analysis. (c) 2023 Elsevier Inc. All rights reserved. Elsevier 2024-06 Article PeerReviewed Plascevic, Josip and Shah, Shaneel and Tan, Yew Wei (2024) Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions. Journal of Pediatric Surgery, 59 (6). pp. 1019-1027. ISSN 0022-3468, DOI https://doi.org/10.1016/j.jpedsurg.2023.10.066 <https://doi.org/10.1016/j.jpedsurg.2023.10.066>. https://doi.org/10.1016/j.jpedsurg.2023.10.066 10.1016/j.jpedsurg.2023.10.066
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Plascevic, Josip
Shah, Shaneel
Tan, Yew Wei
Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions
description Background: The literature on transitional care in anorectal malformation (ARM) and Hirschsprung's disease (HD) is diverse and heterogeneous. There is a lack of standards and guidelines speci fic to transitional care in these conditions. We aim to establish and systematically categorize challenges and solutions related to colorectal transition care. Methods: Systematic review of qualitative studies from MEDLINE, EMBASE, PubMed and Scopus databases (2008-2022) was conducted to identify the challenges and solutions of healthcare transition speci fic to ARM and HD. Thematic analyses are reported with reference to patient, healthcare provider and healthcare system. Results: Sixteen studies from 234 unique articles were included. Fourteen themes related to challenges and solutions, each, are identi fied. Most challenges identi fied are patient related. The key challenges pertain to: (1) patient's lack of understanding of their disorder, resulting in over -reliance on the pediatric surgical team and reluctance towards transitioning to adult services; (2) a lack of education and awareness among adult colorectal surgeons in caring for pediatric colorectal conditions and inadequate communication between pediatric and adult teams; and (3) a lack of structured transition program and joint -clinic to meet the needs of the transitioning patients. The key solutions are: (1) fostering young adult patient's autonomy and independence; (2) conducting joint pediatric -adult transition clinics; and (3) ensuring a structured and coordinated transition program is available using a standardized guideline. Conclusion: A comprehensive framework related to barriers and solutions for pediatric colorectal transition is established to help benchmark care quality of transitional care services. Level of Evidence: IV. Type of Study: Systematic review without meta -analysis. (c) 2023 Elsevier Inc. All rights reserved.
format Article
author Plascevic, Josip
Shah, Shaneel
Tan, Yew Wei
author_facet Plascevic, Josip
Shah, Shaneel
Tan, Yew Wei
author_sort Plascevic, Josip
title Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions
title_short Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions
title_full Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions
title_fullStr Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions
title_full_unstemmed Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions
title_sort transitional care in anorectal malformation and hirschsprung's disease: a systematic review of challenges and solutions
publisher Elsevier
publishDate 2024
url http://eprints.um.edu.my/45197/
https://doi.org/10.1016/j.jpedsurg.2023.10.066
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score 13.211869

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