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Type 1 diabetes: addressing the transition from pediatric to adult-oriented health care

Authors Monaghan M, Baumann K

Received 25 November 2015

Accepted for publication 29 January 2016

Published 13 April 2016 Volume 2016:6 Pages 31—40

DOI https://doi.org/10.2147/RRED.S56609

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Mingzhao Xing


Maureen Monaghan,1,2 Katherine Baumann2

1Center for Translational Science, Children's National Health System, 2George Washington University School of Medicine, Washington, DC, USA

Abstract: Adolescents and young adults with type 1 diabetes are at risk for poor health outcomes, including poor glycemic control, acute and chronic complications, and emergency department admissions. During this developmental period, adolescent and young adult patients also experience significant changes in living situation, education, and/or health care delivery, including transferring from pediatric to adult health care. In recent years, professional and advocacy organizations have proposed expert guidelines to improve the process of preparation for and transition to adult-oriented health care. However, challenges remain and evidence-based practices for preparing youth for adult health care are still emerging. Qualitative research suggests that adolescent and young adult patients rely on health care providers to guide them through the transition process and appreciate a gradual approach to preparing for adult-oriented health care, keeping parents in supportive roles into young adulthood. Patients also benefit from specific referrals and contact information for adult care providers. Promising models of transition care include provision of transition navigators, attendance at a young adult bridge clinic, or joint visits with pediatric and adult care providers. However, much of this research is in its early stages, and more rigorous trials need to be conducted to evaluate health outcomes during transition into adult health care. The purpose of this review is to provide an overview of the transition process, patient and health care provider perceptions of transition care, and emerging evidence of successful models of care for engagement in adult-oriented health care. Recommendations and resources for health care providers are also presented.

Keywords: type 1 diabetes, transition to adult care, health care delivery, adolescents, young adults
 

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