title: Systematic Review of the Impact of Transition Interventions for Adolescents With Chronic Illness on Transfer From Pediatric to Adult Healthcare.
abstract: Transfer from pediatric to adult care is a critical component of a high-quality transition experience for adolescents and young adults (AYA) with chronic illness. To examine the current evidence regarding the effect of transition interventions on care transfer, we performed a systematic review of studies that evaluated the effect of transition interventions on the specific health services outcome of transfer. The Medline, CINAHL, and PsycINFO databases were searched for studies that evaluated 1) a discrete transition intervention for AYA, 2) included a comparison group, and 3) reported on the outcome of transfer from pediatric to adult healthcare. References were screened and reviewed separately by authors, and relevant study details were abstracted during the review process. Five studies from five different countries were included in the final analysis. All five studies were conducted in specialty care clinics, with three interventions involving a nurse practitioner or systems navigator and two interventions involving physicians. Four studies were retrospective observational studies, and one was a pilot randomized controlled trial. Three of the five studies found that the transition intervention was associated with increased rates of transfer while the other two showed no statistically significant effects. Overall, evaluation of transfer appears to be hindered by methodological challenges. Establishing clearer definitions and metrics of transfer and creating the infrastructure needed to monitor the transfer of patients more consistently are important goals.
authors.affiliation: Duke University School of Medicine, Durham, NC. Electronic address: patricia.chu@duke.edu.
authors.forename: Patricia Y
authors.initials: PY
authors.lastname: Chu
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC; Department of Psychiatry, Duke University School of Medicine, Durham, NC.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Maslow
authors.affiliation: Duke University Medical Center Library.
authors.forename: Megan
authors.initials: M
authors.lastname: von Isenburg
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010372:Pediatrics / Q000379:methods; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D060305:Transition to Adult Care / Q000458:organization & administration*; D055815:Young Adult
keywords: Adolescents; Chronic illness; Healthcare transfer; Healthcare transition; Young adults