Transition from pediatric to adult care of children with chronic endocrine diseases: a survey on the current modalities in Italy.
We report on a survey carried out in 65 pediatric and adult endocrinological centers concerning: 1) the modalities of the transfer of children with chronic endocrine diseases from pediatricians to adult endocrinologists, 2) opinions and suggestions from physicians of the Centers, and 3) specific details regarding GH deficiency. The main results are: 1) The mean age of transfer is around 18 yr of age. 2) The reasons for the transfer are personal convincement of pediatricians in 47%, administrative reasons in 37% and patient's desire in 16% of cases 3) In the majority of cases a discharge summary is sent by the pediatrician to the endocrinologist often followed by a phone call, whereas 30% of endocrinologists do not send a report back to pediatricians. 4) Less than half of the Centers are satisfied with the modalities of the transfer and the remainder complain about the lack of communication, no common guidelines, and differences in the management of patients. However, all are willing to try to improve this important time for adolescents with chronic diseases. 5) As far as GH deficiency is concerned, the main differences between pediatric and adult endocrinological centers are the different tests used to re-evaluate the diagnosis and the higher doses of GH used by pediatricians to treat young adults. In conclusion, considering the interest and desire of physicians, a structural intervention of the scientific societies to help to overcome problems is highly desirable.
Department of Pediatrics, University of Parma, Parma, Italy.
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Volta
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Luppino
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Street
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Bernasconi
D000293:Adolescent; D000295:Adolescent Medicine / Q000379:methods; D000328:Adult; D000367:Age Factors; D002908:Chronic Disease; D003266:Continuity of Patient Care; D004700:Endocrine System Diseases / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine / Q000379:methods; D007558:Italy; D010372:Pediatrics / Q000379:methods; D010820:Physicians; D012017:Referral and Consultation