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Improving the transition between paediatric and adult healthcare: a systematic review
Abstract
Introduction The transition between paediatric and adult care for young people with chronic illness or disability is often poorly managed, with adverse consequences for health. Although many agree that adolescent services need to be improved, there is little empirical data on which policies can be based. Objectives To systematically review the evidence of effectiveness of transitional care programmes in young people aged 11-25 with chronic illness (physical or mental) or disability, and identify their successful components. Design A systematic literature review in July 2010 of studies which consistently evaluated health outcomes following transition programmes, either by comparison with a control group or by measurement pre-intervention and post-intervention. Results 10 studies met the inclusion criteria, six of which showed statistically significant improvements in outcomes. Descriptive analysis identified three broad categories of intervention, directed at: the patient (educational programmes, skills training); staffing (named transition co-ordinators, joint clinics run by paediatric and adult physicians); and service delivery (separate young adult clinics, out of hours phone support, enhanced follow-up). The conditions involved varied (eg, cystic fibrosis, diabetes mellitus), and outcome measures varied accordingly. All six interventions that resulted in significant improvements were in studies of patients with diabetes mellitus, with glycosylated haemoglobin level, acute…
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“A systematic review of the literature on the transfer of care among different chronic diseases suggested that the most commonly used strategies in successful programmes were patient education and specific transition clinics jointly staffed by paediatric and adult physicians or dedicated young adult clinics within adult services (156).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [156]
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“Poor health outcomes were also reported in patients with pediatric cancers and cardiac surgery (7-9).”
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“The Transition Research Programme sought to establish how successful transition; defined as “the purposeful, planned process that addresses the medical, psychosocial, educational, and vocational needs of adolescents and young adults with chronic medical and physical conditions as they move from child-centred to adult-…”
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InfluentialJanssens, N., WILDER, L. V., Antonino, L., BERGHE, S. V. D., Haeghen, N. V. D., HECKE, A. V., Hoorenbeeck, K. V., Vandenwyngaert, K., Vyverman, L., Goossens, E., et al. (2026) · Patient Education and Counseling · doi:10.1016/j.pec.2026.110332
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“…care, important knowledge gaps in real-world data and effectiveness remain [5,14], particularly regarding which programme elements are most beneficial in specific contexts and populations, process-level factors such as uptake and implementation, and experiences of patients and caregivers [15,17].”
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Transition Care for Young People with Rare Bone and Mineral Conditions: A Scoping Review
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“Disruptions in care can delay identi fi cation of disease progression and access to rehabilitative and psychosocial support, leading to worse morbidity and mortality (54, 55).”
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“11,12 Despite this, transition practices for AYAs with IBD are heterogeneous and often absent.”
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“…education programs (e.g., transition workshop or a tour) with focus on preparing youth and YAs with CCN for the adult-oriented healthcare system improved outcomes such as medication adherence, quality of life, and self-care measures (Bomba et al., 2017; Crowley et al., 2011; Schmidt et al., 2020).”
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“It is vital to consider barriers to achieving a healthy weight status from the adolescent perspective, beyond those identi fi ed by parents (Darling et al., 2018), given increasing autonomy during this developmental period (Crowley et al., 2011; Taube-Schiff and Yufe, 2017).”
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“Transition of patients with chronic disease from pediatric to adult-oriented health care has tremendous effects on the physical, psychological and psychosocial health of the involved patients and their families [4,5].”
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“The transition from paediatric to adult care services for chronic conditions including diabetes is poorly managed in most units and is carried into young adulthood [3].”
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“clinic attendance, mean HbA1c, self-reported “transition experience”, presence of complications, complication screening rates and DKA admissions) (Crowley et al., 2011; Hanna & Woodward, 2013; Lyons et al., 2014; O’Hara et al., 2017).”
BackgroundGelingende Transition zum Erwachsenenalter
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Erfolgreicher Übergang in die Erwachsenenmedizin
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Transitioning Youth With Attention Deficit Hyperactivity Disorder to Adult Health Care
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Promoting Health for Children and Youth With Special Health Care Needs
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Evaluation of liver transition services for young people at a UK paediatric hospital
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Placebo Effect or Not: Yoga Therapy in Children With Functional Abdominal Pain.
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“Well-planned and coordinated transition from pediatric to adult care has been shown to improve outcomes in AYA patients with chronic diseases (7); however, similar studies in IBD are lacking.”
BackgroundTransition – ein erfolgreiches Konzept in der Behandlung der JIA
Minden, K., & Niewerth, M. (2015) · Aktuelle Rheumatologie · doi:10.1055/s-0035-1545322
Pledging the health of the nation's children.
Glasper, A. (2015) · British Journal of Nursing · doi:10.12968/bjon.2015.24.12.646
Begley, T. (2014) · Evidence-Based Nursing · doi:10.1136/eb-2014-101780
Transitioning from child to adult care
Sassi, R. B. (2014) · doi:10.2217/ebo.13.558
Cramm, J. M., Strating, M., Sonneveld, H., & Nieboer, A. (2013) · Tijdschrift voor kindergeneeskunde · doi:10.1007/s12456-013-0164-1
Mäkeläinen, P., & Korhonen, A. (2013) · doi:10.11124/jbisrir-2013-990
“JBI Database of Systematic Reviews and Implementation Reports JBL000739 2013;11(6) 181 - 196”
BackgroundComplicated Patients Transitioning From Pediatric to Adult Care
Webber, E. (2011) · AAP Grand Rounds · doi:10.1542/gr.26-5-56
Gluten-related disorders: monitoring and follow-up
Al-Toma, A. A., & Mulder, C. J. J. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-821846-4.00012-7
Self-Management Support for Young People with Chronic Conditions: Roles and Views of Professionals
McDonagh, J. E. R. (2021) · Springer eBooks · doi:10.1007/978-3-030-64293-8_5
Metadata
- Authors
- Crowley, R., Wolfe, I., Lock, K., & McKee, M.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Wolfe, I
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2011-03-08
- Volume
- 96
- Issue
- 6
- Pages
- 548-553
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- OpenAlex
- W2121649468
- Cited by
- 649
- References
- 0
- Citations by year
- 2026: 29 · 2025: 27 · 2024: 25 · 2023: 33 · 2022: 45 · 2021: 44 · 2020: 49 · 2019: 54 · 2018: 43 · 2017: 57 · 2016: 53 · 2015: 56 · 2014: 47 · 2013: 44 · 2012: 32
- FWCI
- 7.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Disease in Childhood (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child and Adolescent Health
- Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
- Keywords
- care transitions, chronic disease, disability, youth, diabetes mellitus, patient education, glycosylated haemoglobin, health outcomes
- MeSH terms
- Adolescent, Adult, Child, Chronic Disease, Continuity of Patient Care, Delivery of Health Care, Health Services Research, Humans, Patient Education as Topic, Adolescent Health Services, Outcome Assessment, Health Care, Young Adult
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