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Dwyer AA, Héritier V, Llahana S, Edelman L, Papadakis GE, Vaucher L, Pitteloud N, Hauschild M. Navigating Disrupted Puberty: Development and Evaluation of a Mobile-Health Transition Passport for Klinefelter Syndrome. Front Endocrinol (Lausanne) 2022; 13:909830. [PMID: 35813640 PMCID: PMC9264386 DOI: 10.3389/fendo.2022.909830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Klinefelter syndrome (KS) is the most common aneuploidy in men and has long-term sequelae on health and wellbeing. KS is a chronic, lifelong condition and adolescents/young adults (AYAs) with KS face challenges in transitioning from pediatric to adult-oriented services. Discontinuity of care contributes to poor outcomes for health and wellbeing and transition programs for KS are lacking. We aimed to develop and test a mobile health tool (KS Transition Passport) to educate patients about KS, encourage self-management and support successful transition to adult-oriented care. First, we conducted a retrospective chart review and patient survey to examine KS transition at a university hospital. Second, we conducted a systematic scoping review of the literature on AYAs with KS. Last, we developed a mobile health transition passport and evaluated it with patient support groups. Participants evaluated the tool using the System Usability Scale and Patient Education Materials Assessment Tool (PEMAT). Chart review identified 21 AYAs diagnosed between 3.9-16.8 years-old (median 10.2 years). The survey revealed only 4/10 (40%) were on testosterone therapy and fewer (3/10, 30%) had regular medical care. The scoping review identified 21 relevant articles highlighting key aspects of care for AYAs with KS. An interprofessional team developed the mobile-health KS transition passport using an iterative process. Support group members (n=35) rated passport usability as 'ok' to 'good' (70 ± 20, median 73.5/100). Of PEMAT dimensions, 5/6 were deemed 'high quality' (86-90/100) and participants knew what to do with the information (actionability = 83/100). In conclusion, many patients with KS appear to have gaps in transition to adult-oriented care. Iterative development of a KS transition passport produced a mobile health tool that was usable, understandable and had high ratings for actionability.
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Affiliation(s)
- Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
- Endocrinology, Diabetes & Metabolism Service of the Department of Medicine, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Vanessa Héritier
- Pediatric Endocrinology, Diabetes and Obesity Unit, Department of Women-Mother-Child, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Sofia Llahana
- School of Health and Psychological Sciences, City University of London, London, United Kingdom
| | - Lauren Edelman
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Georgios E. Papadakis
- Endocrinology, Diabetes & Metabolism Service of the Department of Medicine, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Laurent Vaucher
- Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Nelly Pitteloud
- Endocrinology, Diabetes & Metabolism Service of the Department of Medicine, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Michael Hauschild
- Pediatric Endocrinology, Diabetes and Obesity Unit, Department of Women-Mother-Child, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- *Correspondence: Michael Hauschild,
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