A Canadian study has highlighted the importance of improving the transition from pediatric to adult diabetes care in adolescents with type 1 diabetes.
Scientists from the Research Institute of the McGill University Health Centre (RI-MUHC) found "huge gaps" in transition care practices, which can impact adolescent self-management and subsequent attendance at follow-up visits.
"The transition from pediatric to adult care is a huge and complex process that is not unique to type 1 diabetes," said lead author Dr. Meranda Nakhla.
"As healthcare practitioners, we need to start the transition process early and not in the year before adolescents get transferred to adult care. We also need to make more efforts to engage families and guide parents to progressively give their teenagers more responsibility without taking unnecessary risks."
Nakhla and colleagues conducted in-depth interviews in 12 Canadian diabetes centres with diabetes nurses, educators, pediatricians and pediatric endocrinologists between June and November 2015. While the majority of care providers recognised the importance of transition care, only 25 per cent reported having suitable preparation and planning in their diabetes centres.
Reasons for these barriers included
1. lack of adult care providers,
2. less flexibility in scheduling adult healthcare appointments and
3. secondary education or employment of adolescents. A
4. nother significant factor was the pediatric providers’ lack of time in planning for transition,
5. as well as a lack of resources.
"We found there were huge gaps in transition care practices such as
6. the lack of a standardized transition care policy,
7. limited communication between the pediatric and adult healthcare settings a
8. nd an absence of structure for pediatric care providers to implement transition care practices," said Nakhla.
Nakhla stressed that care providers had good intentions, but more structure and guidance is required to better implement transition. Failure to do so can leave adolescents vulnerable.
"Previous studies have shown that transition is a vulnerable period when adolescents tend to fall out of medical care, meaning that once they leave pediatric care to be transferred to adult care they do not have regular follow up for their chronic illness."
The findings were published in the BMJ Open Diabetes Research and Care journal.
www red DiabetologNytt