title: How adult specialists deal with the principles of a successful transition.
abstract: OBJECTIVE
  To evaluate whether adult specialists comply with the basic principles for a successful transition of adolescents with chronic disorders, and to determine whether the characteristics of the adult specialists have an influence on applying these principles.
  
  
  METHODS
  Out of 299 adult specialists in four French-speaking Swiss cantons, 209 (70%) answered a paper-and-pencil mailed questionnaire between May and July 2007. Only those having received the transfer of at least one adolescent in the previous 2 years (N=102) were included in the analysis. We analyzed four dependent variables: discussing common concerns of adolescent patients, seeing the patient alone, having a transition protocol, and having a previous contact with the pediatric specialist. A logistic regression was performed for each dependent variable controlling for the physicians' characteristics (number of transfers, age, gender, workplace, and perceived experience).
  
  
  RESULTS
  Fifty-four percent of the physicians did not spend time alone with their patients, and sensitive issues such as sexuality or substance use were not widely discussed with their young patients. Most respondents (59%) did not have an established protocol, and 54% did not have any contact with the pediatric specialist. In the multivariate analyses, the adult specialists' characteristics had little impact.
  
  
  CONCLUSIONS
  For many adolescents with chronic disorders the transition from pediatric to adult healthcare seems to be limited to a simple transfer, often lacking adequate communication between physicians. Applying simple but basic principles such as a good coordination between providers would probably improve the quality of healthcare of adolescents with chronic illness.
authors.affiliation: Research Group on Adolescent Health, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland. joan-carles.suris@chuv.ch
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Suris
authors.forename: Christina
authors.initials: C
authors.lastname: Akré
authors.forename: Christoph
authors.initials: C
authors.lastname: Rutishauser
mesh_terms: D000293:Adolescent; D002908:Chronic Disease / Q000628:therapy; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D013557:Switzerland