Invited commentaryTransitioning children with chronic diseases to adult care: Current knowledge, practices, and directions
Section snippets
Policy statements/guidelines
A 2002 policy statement1 approved by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians–American Society of Internal Medicine provides insight on the physician’s role in facilitating the transition process. The article stresses the need for a transition plan that acknowledges some of the challenges that health care professionals face such as advocating for improved health insurance, guaranteeing age-appropriate care, and
Case reports
Kelly et al3 describe two cases related to transitioning young adults with special health care needs. The process utilizes a “Medical Home Model,” which focuses on maintaining a comprehensive and continuous source of care within the community in which the youth resides. Myers4 details a patient’s transition experience while coping with end-stage renal disease, and Anderson and Wolpert5 discuss transitioning patients with diabetes from pediatric to adult-centered care.
Provider Roles and Responsibilities
An important issue identified in the literature is the need to define the role of the primary care provider in the transition process. There are questions surrounding whether the primary care provider should lead and coordinate the transition efforts or simply be an integral part of the transition team. One concern associated with transition of care is health care financing once the patient becomes an adult. Geenan et al6 stated that although locating adequate and affordable insurance was not
Literature reviews
Although transition of care was first discussed in the literature in 1984, Blum15 states that there have been few if any real strides made since that time. There is still no system in place to guarantee that youth with chronic conditions will successfully transition to adult care.
Published literature reviews have addressed different aspects of transition. Some articles describe how the main participants involved in the transition process (patient, family, pediatric, and adult providers) may
Commentaries
The commentaries address barriers to transition, offer recommendations, and provide information as to why successful transition is important. These articles also emphasize the importance of families within the transition process. Families must be educated on the transition process because their roles will change as the patient begins to become more independent in their care. Many commentaries stress that families need to be prepared and included in the transition process.
Several commentaries
Areas for further research
Our review has found that the literature surrounding transitioning the care of young adults with chronic illnesses from pediatric to adult care is limited. Although there are many recommendations regarding who should be transitioned, when transitioning should occur, and how it should happen, empirical data providing evidence of successful implementation are limited. The literature included in this review was unable to offer any instances in which the guidelines or suggestions put forth have
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Cited by (0)
Supported by a grant from the American Board of Pediatrics Foundation.