The Alphabet Strategy and standards of care in young adults with type 1 diabetes

Gholap, Nitin; Pillai, Meera K; Virmani, Sumit; Lee, James; James, Diane; Morrissey, J; Datta, Vipan; Patel, Vinod

doi:10.1177/14746514060060040401

Cited by 15 publications

(14 citation statements)

References 11 publications

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“…9,10 Another focus has been changes to the actual clinic visits by offering joint or transition clinics. [11][12][13] A third approach involves a health care staff member who helps coordinate the transition period. [14][15][16][17] These various approaches [9][10][11][12][13][14][15][16][17] have shown limited and variable improvements with adjustment to and acceptance of T1D, improvements in A1c, reduction in short-term health complications, engagement with services, and successful transfer of care from pediatric to adult providers.…”

Section: What Is Transition Of Care and Why Is It Important?mentioning

confidence: 99%

Technology Use in Transition-Age Patients With Type 1 Diabetes

Los

Ulrich

Guttmann‐Bauman

2016

J Diabetes Sci Technol

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Youth with chronic illnesses have the greatest risk for a decline in their health management during transition-age. Because of this demonstrated and well-known issue, research has focused on how to improve the transition of care process. Despite the increasing number of technological devices on the market and the advances in telemedicine modalities available to patients with type 1 diabetes (T1D), the utilization of technology is still suboptimal among patients of transition-age (ages 13-25). This article reviews the available resources, patterns of use in transition-age youth, and explores opportunities to advance technology use in transitioning patients with T1D from pediatric to adult care.

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Section: What Is Transition Of Care and Why Is It Important?mentioning

confidence: 99%

Technology Use in Transition-Age Patients With Type 1 Diabetes

Los

Ulrich

Guttmann‐Bauman

2016

J Diabetes Sci Technol

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“…All 33 studies examined transition in the context of a specific medical condition as opposed to examining transition for all youth with or without chronic conditions. Twelve studies evaluated programs for patient with diabetes mellitus (DM), [15][16][17][18][19][20][21][22][23][24][25][26] 4 for transplant recipients, [27][28][29][30] 3 each for those with arthritis [31][32][33] and sickle cell disease, 34-36 2 for patients with cystic fibrosis, 37,38 and 1 study each for those with cancers, 39 congenital adrenal hyperplasia, 40 HIV, 41 mental health conditions, 42 inflammatory bowel disease, 43 spina bifida, 44 and kidney failure. 45 One study looked at a combination of patients with traumatic brain injury, cerebral palsy, spina bifida, and degenerative muscular disorders.…”

Section: Study Populationsmentioning

confidence: 99%

Measuring the “Triple Aim” in Transition Care: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVES: Without adequate support, adolescents transitioning from the pediatric to the adult health care system are at increased risk for poor health outcomes. Numerous interventions attempt to improve this transition, yet few comprehensively evaluate efficacy. To advance evaluation methods and ultimately the quality of transition services, it is necessary to understand the current state of health care transition measurement. This study examines and categorizes transition measures by using the “Triple Aim” framework of experience of care, population health, and cost of care. METHODS: Ovid Medline and the Cumulative Index to Nursing and Allied Health Literature were searched for articles published between 1995 and 2013. Two reviewers independently screened studies and included those that evaluated the impact of a health care transition intervention. Measures were subsequently classified according to population health, experience of care, and costs of care. RESULTS: Of the 2282 studies initially identified, 33 met inclusion criteria. Population health measures were used in 27 studies, with disease-specific measures collected most frequently. Fifteen studies measured cost, most often service utilization. Eight studies measured experience of care, with satisfaction assessed most commonly. Only 3 studies examined all 3 domains of the “Triple Aim.” Transition interventions described in the gray literature were not reviewed. CONCLUSIONS: Transition programs are inconsistently evaluated in terms of their impact on population health, patient experience, and cost. To demonstrate improvement in the transition from pediatric to adult health care, a more robust and consistent set of measures is needed.

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“…36,41 The remainder studied a variety of conditions including congenital adrenal hyperplasia, 21 HIV, 24 epilepsy, 25 juvenile idiopathic arthritis, 38 spina bifida, 42 cystic fibrosis, 37 or inflammatory bowel disease 43 or included a patient population comprising .1 chronic disease. 20,35,44 Twelve studies were conducted in Europe: 8 in the United Kingdom, 21,22,29,32,35,36,39,50 1 in Germany, 33 1 in Spain, 40 and 2 in 26 One study included data from the United Kingdom and Australia. 24 Few studies used a concurrent comparison group.…”

Section: Patients and Conditions Represented In Evaluation Studiesmentioning

confidence: 99%

“…27,[30][31][32] Seven studies used HbA1c levels as outcomes. [27][28][29]31,32,39,40 Patient satisfaction was the focus of 2 studies. 27,31 Five studies included some sort of comparison group, 27,28,30,32,39 with 3 using concurrent comparators, 27,28,32 although the analyses were retrospective.…”

Section: Diabetesmentioning

confidence: 99%

“…[27][28][29][30][31][32]39,40 Interventions included use of a transition coordinator (n = 2), 27,29 attendance of the pediatrician at the adult care visit(s) (n = 2), 27,31 education and skill building (n = 3), 28,39,40 a specialized young adult clinic (n = 4), 28,29,32,39 and use of technology for education and reminders (n = 2). 29,30 In 5 models, patients transferred directly into an adult clinic.…”

Section: Diabetesmentioning

confidence: 99%

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Transition Care for Children With Special Health Care Needs

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: More children with special health care needs are surviving to adulthood and entering the adult health care system. Effective transition of care can promote continuity of developmental and age-appropriate care for these individuals. WHAT THIS STUDY ADDS:Existing studies provide modest transition care support. Methods for providing transition care warrant attention, and future research needs are wide ranging. Consistent and accepted measures of transition success are critical to establishing an adequate body of literature to affect practice. abstractBACKGROUND: 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.

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The Alphabet Strategy and standards of care in young adults with type 1 diabetes

Cited by 15 publications

References 11 publications

Technology Use in Transition-Age Patients With Type 1 Diabetes

Technology Use in Transition-Age Patients With Type 1 Diabetes

Measuring the “Triple Aim” in Transition Care: A Systematic Review

Transition Care for Children With Special Health Care Needs

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