The experiences and impact of transition from child to adult healthcare services for young people with Type 1 diabetes: a systematic review

Abstract

Although the impact of healthcare transition on outcomes for young people with Type 1 diabetes is unclear due to the paucity of high-quality studies, transition appears to be associated with decreased clinic attendance. There is some preliminary evidence of a positive impact of structured transition programmes. Experiences of healthcare transition illuminate the barriers to smooth transitions and the need for better integration and continuity of care.

Technology Use in Transition-Age Patients With Type 1 Diabetes

“…4 Another challenge is the variability in age range cited in transition literature. 5 The variation is often related to whether the research is addressing interventions for the transition process, often taking place as early as age 13 or the actual transfer of care which is commonly achieved during "emerging adulthood or age [18][19][20][21][22][23][24][25]." 1,6,7 For this article, we reviewed articles focused on technology use in youth with T1D age 13-25 years, as it is the population most often defined as "transition-aged youth."…”

Systematic Review of the Impact of Transition Interventions for Adolescents With Chronic Illness on Transfer From Pediatric to Adult Healthcare

“…Reiss & Gibson, 2002; Sable et al, 2011; Tuchman, Schwartz, Sawicki, & Britto, 2010). The increased attention is due, in part, to a growing body of evidence that shows that AYA access to and use of healthcare services declines significantly during the transitional period and that this decline in health service utilization is associated with worse health outcomes(Blinder et al, 2013; Camfield & Camfield, 2011; Hemker, Brousseau, Yan, Hoffmann, & Panepinto, 2011; Lotstein et al, 2013; Sawyer, Drew, Yeo, & Britto, 2007; Sheehan, While, & Coyne, 2015). Recent systematic reviews of the transition experiences of young adults with type 1 diabetes and congenital heart disease have shown that young adults have a much lower clinic attendance rate after transferring to adult care(Heery, Sheehan, While, & Coyne, 2015; Sheehan et al, 2015).…”

“…The increased attention is due, in part, to a growing body of evidence that shows that AYA access to and use of healthcare services declines significantly during the transitional period and that this decline in health service utilization is associated with worse health outcomes(Blinder et al, 2013; Camfield & Camfield, 2011; Hemker, Brousseau, Yan, Hoffmann, & Panepinto, 2011; Lotstein et al, 2013; Sawyer, Drew, Yeo, & Britto, 2007; Sheehan, While, & Coyne, 2015). Recent systematic reviews of the transition experiences of young adults with type 1 diabetes and congenital heart disease have shown that young adults have a much lower clinic attendance rate after transferring to adult care(Heery, Sheehan, While, & Coyne, 2015; Sheehan et al, 2015). For example, one Canadian study of AYA with complex congenital heart disease found that less than half of the young adults studied successfully transferred to the adult heart center within a 2 year period and that patients who did not transfer reported significantly more comorbidities than those who did (Reid et al, 2004).…”

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

“…Transition to adult-oriented health care at younger ages has been associated with poorer glycemic control 9 and late adolescents who remain in pediatric care into early young adulthood demonstrate better glycemic control and fewer hospitalizations as compared to those who transfer to adult care. 34,51 However, evidence on the impact of transition on glycemic control is inconsistent, and one recent review 38 found that young adults generally maintained stable or even improved glycemic control after the transfer to adult medical care. This is similar to large cohort studies that report a general improvement in glycemic control in the mid-20s.…”