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Transition From Pediatric to Adult Care in Epilepsy (TRANSITA)

2026年5月11日 更新者：Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Transitioning From Pediatric to Adult Care in Epilepsy: Efficacy of a Novel Italian Model

The transition from pediatric to adult healthcare services for individuals with epilepsy represents a major clinical and organizational challenge. This complexity arises from the heterogeneity of the underlying epileptic disorders and the frequent presence of multiple comorbidities. Furthermore, the process entails a profound shift in the patient-physician relationship, which must be re-established to allow open discussion of sensitive issues and to adapt to a different model of care.

In pediatric settings, medical care is predominantly family-centered, with parents actively involved in the decision-making process. In contrast, adult care is primarily patient-centered, emphasizing individual autonomy and self-management. The **transition** therefore constitutes a structured process designed to prepare adolescents and young adults for adult-oriented healthcare. It aims to enhance their understanding of epilepsy, increase awareness of available treatments, and develop self-management skills that help minimize the long-term psychosocial and medical impact of the disorder.

The **transfer**, by contrast, refers to the formal handover of medical responsibility from pediatric to adult healthcare providers. While transfer is an event, transition represents a multidimensional process that should begin well before the actual shift of care.

Over the past decade, several studies have sought to address the challenges associated with this critical phase by proposing transitional programs based on different organizational models. These structured interventions are designed to bridge the gap between pediatric and adult services, fostering continuity of care and improving clinical outcomes.

A recent and promising example is a **French transitional model**, published following a retrospective study involving 70 persons with epilepsy (PWE). This model provided evidence supporting the feasibility and benefits of a dedicated, multidisciplinary transition program tailored to the specific needs of young individuals with epilepsy.

In contrast, within the Italian scientific and clinical context-particularly in the field of epilepsy-no formally structured or validated transition program has yet been established. This gap underscores the need for the development of standardized national guidelines and the implementation of evidence-based transitional pathways.

A well-designed transition program can significantly facilitate the adjustment of adolescents to adult neurological care, promoting therapeutic adherence, clinical stability, and psychosocial well-being. Ultimately, structured transitional care represents a crucial step toward ensuring continuity, safety, and quality of care for individuals with epilepsy as they move from pediatric to adult health services.

調査の概要

状態

募集

条件

介入・治療

研究の種類

観察的

入学 (推定)

64

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

  • イタリア
      • Roma、イタリア
        • 募集
        • Fondazione Policlincio Universitario Agostino Gemelli
        • コンタクト：
        • 主任研究者：
          • Domenica Immacolata Battaglia
        • 副調査官：
          • Maria Picilli

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 子
  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

サンプリング方法

確率サンプル

調査対象母集団

People with epilepsy who are transitioning from pediatric care to an adult neurologist's outpatient clinic.

説明

Inclusion Criteria:

Prospective Study

Case Group:

  • Persons with epilepsy (PWE) or epileptic syndromes (6,7) without intellectual disability (ID); PWE with mild ID, with or without comorbidities; and individuals diagnosed with tuberous sclerosis complex.
  • PWE who are at least 15 years old at the time of the DH BRIDGE admission.
  • PWE who are regularly followed at the Fondazione Policlinico Universitario A. Gemelli IRCCS, with documentation of at least two prior evaluations conducted at the Child Neuropsychiatry Unit.
  • Signed informed consent obtained from the parents or legal guardians, or from the patient if of legal age. In cases where an adult patient is unable to provide informed consent, authorization will be obtained from a parent or legal guardian.
  • Signed assent form from the minor participant.

Control Group:

  • Persons with epilepsy (PWE) or epileptic syndromes (6,7) without intellectual disability (ID); PWE with mild ID, with or without comorbidities; and individuals diagnosed with tuberous sclerosis complex.
  • PWE who are at least 18 years old at the time of their first visit to the Adult Neurology Outpatient Clinic.
  • PWE who are regularly followed at the Fondazione Policlinico Universitario A. Gemelli IRCCS, with documentation of at least two visits at the Day Hospital for Drug-Resistant Epilepsies.
  • Signed informed consent obtained directly from the patient or, in cases of incapacity, from the parents or legal guardian.

Retrospective Study

  • Persons with epilepsy (PWE) or epileptic syndromes without intellectual disability (ID); PWE with mild ID, with or without comorbidities; and individuals diagnosed with tuberous sclerosis complex.
  • PWE who were over 18 years of age at the time of their first visit to the Adult Neurology Outpatient Clinic, and who have completed at least six months of follow-up after that visit. When available, follow-up data at 12 months will also be collected.
  • PWE who have been regularly followed at the Fondazione Policlinico Universitario A. Gemelli IRCCS, with at least two documented visits conducted at the same institution.
  • Signed informed consent obtained directly from the patient or, in cases of incapacity, from the parents or legal guardian.

Exclusion Criteria:

-Patients will be excluded if they are not regularly followed at the Day Hospital for the Diagnosis and Treatment of Drug-Resistant Epilepsies (fewer than two visits).

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
CASE group
The study will include persons with epilepsy (PWE) or epileptic syndromes, with or without mild intellectual disability, and individuals with tuberous sclerosis complex. Participants may have comorbidities that do not hinder their participation in transitional care. Eligible subjects must be ≥15 years at the time of the DH BRIDGE and regularly followed at Fondazione Policlinico Universitario A. Gemelli IRCCS (≥2 visits). Informed consent will be obtained from patients or guardians, and assent from minors, ensuring an ethically and clinically appropriate cohort for transitional care evaluation.
診断テスト：EpiTRAQ
Clinical and neuropsychological evaluations with standardised and internationally validated questionnaires and interviews, already used in clinical practice.
他の名前：
  • QOLIE-31
CONTROL group
The control group will include adults (≥18 years) with epilepsy or epileptic syndromes, with or without mild intellectual disability, and individuals with tuberous sclerosis complex. Participants may have comorbidities that do not interfere with standard adult neurological care. All must be regularly followed at Fondazione Policlinico Universitario A. Gemelli IRCCS, with at least two documented visits. Informed consent will be obtained from each participant or, if incapacitated, from a legal guardian, ensuring a clinically comparable and ethically sound reference group.
診断テスト：EpiTRAQ
Clinical and neuropsychological evaluations with standardised and internationally validated questionnaires and interviews, already used in clinical practice.
他の名前：
  • QOLIE-31

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Adult Clinic Attendance Rate
時間枠：12 months
The percentage of patients (for each group) who attend their first scheduled adult clinic appointment, as organized by the pediatric team. The study aims to compare the Attendance Rate in adult care with a minimum of 6-12 months between case and control groups.
12 months
Return Rate:
時間枠：12 months
The percentage of patients (for each group) who request a follow-up visit with their pediatric neurologist or return to the pediatric center after the transfer. The study aims to compare the Return Rate with a minimum of 6-12 months between the case and control groups.
12 months

二次結果の測定

結果測定
メジャーの説明
時間枠
Adult Clinic Attendance Rate and the EpiTRAQ
時間枠：36 months
To Evaluate associations between Adult Clinic Attendance Rate and the EpiTRAQ score for each group.
36 months
Return Rate and the EpiTRAQ
時間枠：36 months
To Evaluate associations between the Return Rate and the EpiTRAQ score for each group.
36 months
QOLIE-31
時間枠：36 months
Assessment of the Quality of Life with questionnaire
36 months

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

捜査官

  • 主任研究者：Domenica Immacolata Battaglia、Fondazione Policlinico Universitario Agostino Gemelli IRCCS

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2025年11月19日

一次修了 (推定)

2028年12月1日

研究の完了 (推定)

2030年12月1日

試験登録日

最初に提出

2025年11月18日

QC基準を満たした最初の提出物

2026年5月11日

最初の投稿 (実際)

2026年5月18日

学習記録の更新

投稿された最後の更新 (実際)

2026年5月18日

QC基準を満たした最後の更新が送信されました

2026年5月11日

最終確認日

2025年11月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • 7918 (CTEP)

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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