Pediatric Rheumatology Online Journal → August 2003 → Health-Care Delivery → Abstract #176

A COMPARISON.OF PAEDIATRIC VS ADULT RHEUMATOLOGY CLINICS. (2) THE ALLIED HEALTH PROFESSIONAL PERSPECTIVE

L. P. Robertson,¹ M. Jolly,¹ N. Day,¹ P. Whitworth,² B. Johnson,² J. Hackett,² J. E. McDonagh.²

¹Dept of Rheumatology, Derriford Hospital, Plymouth, United Kingdom; ²Dept of Paediatric Rheumatology, Diana Princess of Wales Childrens' Hospital, Birmingham, United Kingdom

Background
Transitional care for adolescents with chronic rheumatic disease from paediatric to adult care is multidisciplinary. Doctor and allied health professional (AHP), paediatric and adult clinic differences need consideration. Our aim was to compare paediatric and adult AHP consultations.
Methods
Consecutive outpatient paediatric and adult rheumatology AHP consultations were examined. Demographics, number of people in the consulting room and consultation times were recorded. Patients completed a child or adult health assessment questionnaire (CHAQ or HAQ). The number of people present, consultation times (unpaired t-tests), physician and AHP consultations (chi-squared test) were compared.
Results
Data from 70 paediatric and 28 adult consultations (held within and concurrently to physician-led clinics respectively) was collected. Mean age, M:F ratio 9.65±4.72yrs, 1:1.5 (paeds) and 57.5±13.17yrs, all female (adults), commonest diagnoses: juvenile idiopathic arthritis (65.7%), rheumatoid arthritis (96.4%). Median CHAQ score (for 26/70) 0.76 (range: 0 - 2), median HAQ (for 25/28) 1.5 (range: 0 - 2.75). 4.2% (n=3) of all paediatric pts and 18% (n=2/11) 15yrs were seen alone. 41% attended with mother, 37% with both parents. 92.8% of adults attended alone. Mean number of people present 4.01±0.94 (paeds), 2.5±0.58 (adults) p0.001. Mean consultation time 23.85±10.87 mins (paeds), 14.07±4.81 mins (adults) p0.001. Adults were more likely to see AHPs alone than doctors (92.8% vs 74.3% p=0.02). The proportions of paediatric patients seeing AHPs or doctors alone were similar (4.5% vs 6%, p=0.6 (all); 26.7% vs 18%, p=0.59 (15yrs)).
Conclusions
There are more people at paediatric AHP consultations. Adults were more likely to see AHPs alone than doctors; this difference was not evident in paediatrics even for older teenagers. These issues have implications for consultation dynamics, service provision and preparing teenagers for adult rheumatology services.