title: Transition care for children with special health care needs.
abstract: BACKGROUND
  Approximately 750,000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care.
  
  
  METHODS
  We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs.
  
  
  RESULTS
  We identified 25 studies evaluating transition care programs. Most (n = 8) were conducted in populations with diabetes, with a smaller literature (n = 5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than 2 studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition, and provision of educational materials.
  
  
  CONCLUSIONS
  The issue of how to provide transition care for children with special health care needs warrants further attention. Research needs are wide ranging, including both substantive and methodologic concerns. Although there is widespread agreement on the need for adequate transition programs, there is no accepted way to measure transition success. It will be essential to establish consistent goals to build an adequate body of literature to affect practice.
authors.affiliation: Division of General Pediatrics, and Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee; and.
authors.forename: Alaina M
authors.initials: AM
authors.lastname: Davis
authors.affiliation: Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee; and Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics;
authors.forename: Rebekah F
authors.initials: RF
authors.lastname: Brown
authors.affiliation: Division of General Pediatrics, and Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee; and Vanderbilt University Kennedy Center for Research on Education and Human Development, Nashville, Tennessee.
authors.forename: Julie Lounds
authors.initials: JL
authors.lastname: Taylor
authors.affiliation: Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee; and Division of Child and Adolescent Psychiatry, Department of Psychiatry; and.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Epstein
authors.affiliation: Evidence-Based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee; melissa.mcpheeters@vanderbilt.edu.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: McPheeters
mesh_terms: D000328:Adult; D002648:Child; D019988:Children with Disabilities; D005069:Evaluation Studies as Topic; D006301:Health Services Needs and Demand / Q000592:standards / Q000639:trends*; D006801:Humans; D060305:Transition to Adult Care / Q000592:standards / Q000639:trends*; D055815:Young Adult
keywords: adolescent health services; self-management; special health care needs; transition to adult care