This post offers a curated collection of articles, toolkits, white papers, and/or other resources on strategies to improve the transition of youth from pediatric to adult primary care. Click on the toggle for any reference to view a brief summary of the document, its source, and an active link for access.
Bhawra, J., Toulany, A., Cohen, E., Hepburn, C. M., & Guttmann, A. (2016). Primary care interventions to improve transition of youth with chronic health conditions from paediatric to adult healthcare: A systematic review
Abstract – Objective: To determine effective interventions to improve primary care provider involvement in transitioning youth with chronic conditions from paediatric to adult care. Design: Systematic review. Multiple electronic databases were searched including Ovid MEDLINE, EMBASE and Web of Science (from 1 January 1947 to 5 August 2015). Evidence quality was assessed using a 36-point scoring system for disparate study designs. Setting: Studies with paediatric-to-adult transition programmes and interventions involving primary care providers or in primary care settings. Participants: Youth aged 16 years and over. Outcomes: Relevant outcomes were grouped into 3 main domains based on the Triple Aim Framework: experience of care, population health, cost. Results: A total of 1888 unique citations were identified, yielding 3 studies for inclusion. Overall, primary care provider roles were not well defined. 2 studies used case managers to facilitate referrals to primary care, and the remaining study was the only 1 situated in a primary care setting. None of the studies examined transition in all 3 Triple Aim Framework domains. The most commonly reported outcomes were in the cost domain. Conclusions: There is limited empiric evidence to guide primary care interventions to improve transition outcomes for youth with chronic conditions. Future research and policy should focus on developing and evaluating coordinated transition interventions to better integrate primary care for high need populations.
Bhawra, J., Toulany, A., Cohen, E., Hepburn, C. M., & Guttmann, A. (2016). Primary care interventions to improve transition of youth with chronic health conditions from paediatric to adult healthcare: A systematic review. BMJ Open, 6(5), e011871. https://bmjopen.bmj.com/content/bmjopen/6/5/e011871.full.pdf
Got Transition
Overview: Got Transition is the national resource center on health care transition (HCT). Its aim is to improve the transition from pediatric to adult health care through the use of evidence-driven strategies for clinicians and other health care professionals; public health programs; payers and plans; youth and young adults; and parents and caregivers. Got Transition is a program of The National Alliance to Advance Adolescent Health.
Got Transition. (n.d.). https://www.gottransition.org
Leeb, R. T., Danielson M. L., Bitsko, R. H., Cree, R. A., Godfred-Cato, S., Hughes, M. M., Powell, P., Firchow, B., Hart, L. C., & Lebrun-Harris, L. A. (2020). Support for transition from adolescent to adult health care among adolescents with and without mental, behavioral, and developmental disorders — United States, 2016–2017
Abstract: Clinical guidelines recommend that primary care providers (PCPs) provide guidance and support to ensure a planned transition from pediatric to adult health care for adolescents, beginning at age 12 years. However, most adolescents do not receive the recommended health care transition planning. This is particularly concerning for adolescents with diagnosed mental, behavioral, and developmental disorders (MBDDs), who account for approximately 20% of U.S. adolescents. Childhood MBDDs are linked to increased long-term morbidity and mortality; timely health care transition planning might mitigate adverse outcomes. CDC analyzed pooled, parent-reported data from the 2016 and 2017 National Survey of Children’s Health (NSCH), comparing adolescents, aged 12-17 years, with and without MBDDs on a composite measure and specific indicators of recommended health care transition planning by PCPs. Overall, approximately 15% of adolescents received recommended health care transition planning: 15.8% (95% confidence interval [CI] = 14.1%-17.5%) of adolescents with MBDDs, compared with 14.2% (95% CI = 13.2%-15.3%) of adolescents without MBDDs. Relative to peers without MBDDs and after adjusting for age, adolescents with anxiety were 36% more likely to receive recommended health care transition planning, and those with depression were 69% more likely; adolescents with autism spectrum disorder (ASD) were 35% less likely to receive such transition planning, and those with developmental delay were 25% less likely. Fewer than 20% of adolescents with MBDDs receiving current treatment met the transition measure. These findings suggest that a minority of adolescents with MBDDs receive recommended transition planning, indicating a potential missed public health opportunity to prevent morbidity and mortality in a population at high risk for health care disengagement. Improving access to comprehensive and coordinated programs and services, as well as increasing provider training concerning adolescents’ unique mental and physical health care needs, could help increase the number of adolescents benefiting from successful health care transitions.
Leeb, R. T., Danielson M. L., Bitsko, R. H., Cree, R. A., Godfred-Cato, S., Hughes, M. M., Powell, P., Firchow, B., Hart, L. C., & Lebrun-Harris, L. A. (2020). Support for transition from adolescent to adult health care among adolescents with and without mental, behavioral, and developmental disorders — United States, 2016–2017. Morbidity and Mortality Weekly Report, 69(34), 1156–1160. https://doi.org/10.15585/mmwr.mm6934a2 or http://dx.doi.org/10.15585/mmwr.mm6934a2 or https://www.cdc.gov/mmwr/volumes/69/wr/mm6934a2.htm