Endocrine Abstracts (2017) 51 P017 | DOI: 10.1530/endoabs.51.P017

Turner syndrome transition - audit of paediatric clinic, RHC Glasgow

Joshua Abbas1 & Avril Mason2


1University of Glasgow, Glasgow, UK; 2Royal Hospital for Children Glasgow, Glasgow, UK.


Background: Turner syndrome is a lifelong condition that requires lifelong engagement with health services. The Paediatric Endocrinologist has a role in developing a plan for transition and establishing follow-up in an adult clinic. A clinic proforma outlining expected investigations during transition has been in use in the Glasgow Turner clinic since 2015 based on the recommendations of the Turner Syndrome Study Group. More recently The Endocrine Society Transition Toolkit has provided useful guidance on essential clinical information that should be provided upon transfer to adult practice.

Patients: A total of 17 girls were studied with a median age of 17.6 (15.6–20.6) years, at last paediatric clinic visit, and median age of diagnosis of 1.40 (0–16.3) years.

Criteria to be measured: All girls should have had the following tests in the 2-year period prior to their last appointment with paediatric services to provide comprehensive clinical information to the receiving adult physician on cardiovascular and renal heath; audiology and autoimmune disease.

Methods: Data was collected from individual case notes and electronic records, in all girls, with last Paediatric Turner clinic, 2010–2017. Girls were divided according to whether care was transferred before or after the use of a clinic proforma in 2015. The individual and overall tests are presented as percentages. A chi squared test was applied to assess if there was a difference, overall, before and after 2015 in the number of tests performed.

Results:

Number and percentage of criteria fulfilled
CriteriaPre 2015 n=92015 Onwards n=8P value
Cardiovascular
Cardiac Echocardiogram5 (56%)7 (88%)
Fasting Glucose4 (44%)7 (88%)
Fasting Lipids2 (22%)5 (63%)
Renal
Urea + Electrolytes4 (44%)6 (75%)
Audiology
Hearing Evaluation1 (11%)3 (38%)
Autoimmune
TFTs9 (100%)8 (100%)
Other
LFTs8 (89%)7 (88%)
Overall Tests54%82%0.002

Discussion: A coordinated approach is required to ensure successful paediatric to adult transition including the transfer of essential clinical information. The paediatric endocrinologist should endeavour to develop strategies, including use of a clinic proforma, in their clinic to aid this process.

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