Need and Feasibility of a Transition Clinic for Adolescents with Chronic Illness: A Qualitative Study

To assess the need and feasibility of a Transition Clinic in the care of adolescents with chronic illness.

A qualitative study, piloted by a questionnaire-based survey, followed by Focus Group Discussions was conducted in the Department of Pediatrics in a government teaching hospital in Kerala. The participants were adolescents with chronic disease, viz., renal disease, diabetes, HIV/AIDS, cancer survivors with Hepatitis B, parents of renal patients, pediatricians and adult specialists. Twenty patients were administered a structured, rated, 18-item questionnaire regarding their attitude and preparedness for transfer to adult departments. The need and feasibility of a Transition Clinic was discussed by 7 focus groups viz., pediatricians, adult physicians, 4 patient groups and 1 parent group. Thematic analysis of data was done.

Except among pediatricians, awareness of the concept of Transition Clinic was low. All participants agreed that abrupt transfer of care hinders treatment and that there is a definite need for a Transition Clinic. Pediatricians discussed the complex needs of adolescents and limitations of their care. Adult specialist physicians described their inadequacy to handle adolescent problems and difficulties posed by large volumes of patients. The adolescents and young adults with chronic illness discussed their reluctance to shift to the adult departments. Parents voiced their concerns about the future of their children. All groups gave constructive suggestions for conduct of the clinic and smooth transition.

There is a definite need for a Transition Clinic in the management of adolescents with chronic illness to ensure smooth transfer of care. Introducing such clinics in the existing health framework is feasible using a multidisciplinary approach.