2022 年 39 巻 2 号 p. 78-83
Advances in medical technologies have made it possible for patients with severe motor and intellectual disabilities (SMIDs) to survive into adulthood. Therefore, the pediatric to adult health care transition is necessary for children with SMIDs to adapt to adult life. The causes of SMIDs are categorized according to the period of onset (i.e., prenatal period, perinatal and neonatal period, postnatal period). The diagnostic groups for SMIDs include hypoxia/asphyxia, low–birth–weight infant, chromosome disorders, infections, metabolic disorders, and brain injuries, and so on. Post–transition medical care was optimized by reviewing the diagnosis, adjusting antiepileptic medications, and taking care of the physical condition. With the cooperation of medical social workers and nurses, community–based health care coordination and allocation of social resources for appropriate use of welfare services were promoted. Providing patient–centered adult health care improved comprehension of the disease for patients with SMIDs and their families. Therefore, they were able to determine future care policies with a shared decision–making process. Face–to–face information sharing prior to referral between physicians who care for children and physicians who care for adults, especially for children with SMIDs, is known to be important and facilitates improved care. Furthermore, interprofessional collaboration with pediatricians, adult clinicians, medical social workers, nurses, and other professionals facilitates a better transition for patients with SMIDs. Neurologists engaged in medical care for patients with intractable disease are desired to participate in the transition from pediatric to adult health care. The Special Committee for Measures Against Transition from Pediatric to Adult Health Care of the Japanese Society of Neurology, which is composed of pediatric and adult neurologists, has been working toward a better transition from pediatric to adult health care since July 2020.
