ECE2022 Poster Presentations Pituitary and Neuroendocrinology (127 abstracts)
Transition in endocrinology: predictors of drop-out in a heterogeneous population during long-term follow-up
Martina Romanisio 1 , Sara Brasili 1 , Tommaso Daffara 1 , Alice Ferrero 1 , Davide Vimercati 1 , Francesca Pizzolitto 1 , Rosa Pitino 1 , Edoardo Luigi Maria Mollero 1 , Marco Zavattaro 1 , Simonetta Bellone 2 , Marina Caputo 1,3 , Gianluca Aimaretti 1 & Flavia Prodam 1,3
1Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; 2Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy; 3Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy, Novara, Italy
Aim: To evaluate: 1) clinical and epidemiological characteristics of outpatients transitioned from Pediatrics Endocrine (PED) to Adult Endocrine Department (AED) in a tertiary Centre; 2) transition process characteristics, and predictive factors of drop-out.
Patients and methods: Demographic, clinical, and transition features of 170 consecutive patients with paediatric onset of chronic endocrine or metabolic disease (excluded type 1 diabetes) who transitioned from PED to AED (2007-2020) were retrospectively evaluated.
Results: The age at transition was 18.4±4 years (F:M=1.2: 1). 93.6% of patients were affected by endocrinopathies (19.4% on a genetic basis), while 6.4% were in follow-up only in a cancer-survivor surveillance protocol. 69.4% of patients had one endocrine disease, 20.0% had 2, and 4.2% of them had 3 or more. 40.0% of subjects suffered also from non-endocrine diseases. The total comorbidity burden was high: 37.1%, 20.6%, and 11.1% of patients had 2, 3, 4, or more diseases. The number of treatments progressively increased and was associated with the number of visits (r 0.349, P<0.0001), and the age at the last visit (r 0.184, P<0.0.1). The number of visits was positively associated with the number of endocrine diseases and the etiology (mainly in hypergonadotropic hypogonadism, hypopituitarism). Patients with obesity had the low number of visits (χ2=13.850, P<0.05). 64.7% of patients were adherent to the follow-up, mainly if they had a high number of comorbidities (χ2=14.473, P<0.01) or thyroid disorders (χ2=3.618, P<0.04). Having performed one visit only was predictive of drop-out (χ2=18.624, P<0.009), regardless of pathology. Among cancer survivors, patients treated for central nervous system tumors had the highest adherence.
Conclusions: This is the first study that analyzed a specific transition plan for chronic endocrine diseases on long-term follow-up. The proposed “one size fits all model” is not adequate in responding to the different needs of patients. A structured transition plan is an emerging cornerstone. The first visit is crucial in building a trusting relationship between patients and healthcare providers and plays an important role in a successful therapeutic intervention.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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