| Summary: | Abstract Objective Transitioning patients with childhood‐onset epilepsy to adult care is often challenging, particularly for those with complex medical or social backgrounds. This study aimed to identify key factors associated with a successful transfer to inform strategies that support continuity during this vulnerable period. Methods A retrospective cohort study was conducted using medical records from the National Center for Child Health and Development, a tertiary pediatric hospital in Tokyo, Japan. Patients with epilepsy aged 18 years or older who had regular outpatient visits between January 1 and March 31, 2018, were enrolled and followed until June 30, 2022. Results At the start of the study, 232 patients were identified, 225 patients were evaluated, and 186 (82.7%) were successfully transferred to adult care during the study period. The median age at transfer to adult care was 23 years. Successful transfer was significantly associated with epilepsy etiology, the presence of comorbidities, and support from transition services. Patients requiring assistance with daily living were more likely to transfer to neurologic non‐specialty care facilities, such as psychiatric clinics or home‐based care providers. Significance Identifying factors associated with transition outcomes can help healthcare providers anticipate potential barriers and facilitate smoother transitions for patients with childhood‐onset epilepsy who require ongoing adult care. Plain Language Summary We studied how young people with epilepsy move from children's hospitals to adult healthcare. Most patients successfully transitioned to adult care. During the observation period, transfer was more likely among those with different types of epilepsy and those who received support from transition services. Patients who were also seeing other medical departments tended to transfer less often. Our study highlights factors that may help plan better support for patients with childhood‐onset epilepsy.
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