Healthcare Transition from Pediatric to Adult Medical Homes |
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| Institution: | 1. Diabetes Center of Excellence, Quintiles;2. Diabetes Center of Excellence, University of Florida College of Medicine;3. Division of Endocrinology, Diabetes and Metabolism, University of Florida College of Medicine;4. Clinical Development, Lexicon Pharmaceuticals, The Woodlands, Texas.;1. Medical Corps, Israeli Defense Force, Israel;2. Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel;3. The Chaim Sheba Medical Center, Tel Hashomer, Israel.;1. Department of Pediatrics, University of Washington, Seattle, Washington;2. Division of Pediatric Endocrinology, T.C. Thompson Children’s Hospital, Chattanooga, Tennessee.;1. Endocrinology Center and Clinics, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Division of Endocrinology, Metabolism, and Clinical Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin;3. Division of Endocrinology, Diabetes and Metabolism, Wheaton Franciscan Medical Group, Racine, Wisconsin;4. University of Texas Southwestern Medical School; Dallas, Texas;5. Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, Michigan;6. Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio. |
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| Abstract: | ObjectiveTo review and exemplify the complexities and challenges in healthcare transition from the pediatric medical home to the adult medical home for patients with type 1 and type 2 diabetes mellitus and to highlight the importance of this topic to adult-focused clinical endocrinologists.MethodsWe performed a literature search using PubMed and multiple key words. To set the scene for discussions, we also reviewed landmark publications in the general healthcare transition literature over the last several decades; we provide a brief historical perspective at the beginning of our discussions.ResultsGiven the critical importance of successful healthcare transition, there is little empirical evidence on key aspects of these transitions. The vast majority of the literature focuses on type 1 diabetes because historically, this form has predominantly affected pediatric patients. However, the increasing incidence and prevalence of pediatric patients with type 2 diabetes makes investigations vital for this patient population too. The Treatment Options for Type 2 Diabetes in Adolescents and Youth study has proved informative in this regard.ConclusionCrossing the chasm between pediatric and adult healthcare remains a remarkably flawed transition process. Healthcare transition should be a planned process of discussing and preparing pediatric patients for the transition and then ensuring continued care as an adult; the greater the collaboration of pediatric and adult endocrinologists in this process, the greater the chance of a successful transition. (Endocr Pract. 2014;20:714-720) |
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