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Health Care Transition Preparation and Experiences in a U.S. National Sample of Young Adults With Type 1 Diabetes.
Citation | “Health Care Transition Preparation And Experiences In A U.s. National Sample Of Young Adults With Type 1 Diabetes.”. Diabetes Care, pp. 317-324. . |
Center | Joslin Diabetes Center |
Author | Katharine C Garvey, Nicole C Foster, Shivani Agarwal, Linda A DiMeglio, Barbara J Anderson, Sarah D Corathers, Marisa E Desimone, Ingrid M Libman, Sarah K Lyons, Anne L Peters, Jennifer K Raymond, Lori M Laffel |
Abstract |
OBJECTIVE: Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey to evaluate transition experiences in two groups of young adults with type 1 diabetes, before (PEDS) and after (ADULT) transition to adult care. RESEARCH DESIGN AND METHODS: We fielded an electronic survey to young adults (18 to <30 years) at 60 T1D Exchange Clinic Registry centers. RESULTS: Surveys were completed by 602 young adults, 303 in the PEDS group (60% female, age 20 ± 2 years) and 299 in the ADULT group (62% female, age 24 ± 3 years). In the PEDS group, mean anticipated transition age was 22 ± 2 years; 64% remained in pediatric care because of emotional attachment to the provider. The ADULT group transitioned at age 19 ± 2 years, mainly after pediatric provider recommendation. More than 80% of respondents reported receiving counseling on type 1 diabetes self-management and screening tests from pediatric providers, but less than half (43% PEDS and 33% ADULT) reported discussing reproductive health. In the PEDS group, half had discussed transfer with pediatric providers. Of the ADULT participants, 63% received an adult provider referral, and 66% felt mostly/completely prepared to transition. ADULT participants with fewer pretransition pediatric visits or who felt unprepared for transition had increased odds of gaps >6 months between pediatric and adult care. Receipt of transition preparation counseling was not associated with self-reported hemoglobin A <7.0% in either group. CONCLUSIONS: These results support the need for intensive efforts to integrate transition preparation counseling and care coordination into pediatric type 1 diabetes care. |
Year of Publication |
2017
|
Journal |
Diabetes care
|
Volume |
40
|
Issue |
3
|
Number of Pages |
317-324
|
Date Published |
03/2017
|
ISSN Number |
1935-5548
|
DOI |
10.2337/dc16-1729
|
Alternate Journal |
Diabetes Care
|
PMID |
28007779
|
PMCID |
PMC5319474
|
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