What Do We Need to Know About Transition/Transfer Programs and What Sort of Research Will Answer the Questions?

Area of Science:

• Healthcare transition research
• Chronic disease management
• Pediatric to adult care models

Background:

• Significant knowledge gaps exist regarding the optimal transition of youth with chronic disorders to adult care.
• Current literature lacks comprehensive evaluations of transition programs and their effectiveness.

Purpose of the Study:

• To critically examine the definition, components, effectiveness, and costs of optimal transition programs for youth with chronic disorders.
• To identify areas requiring further research in healthcare transition.

Main Methods:

• Review of existing literature on transition programs, focusing on neurological, diabetes, renal transplant, and rheumatologic disorders.
• Analysis of available evidence regarding the effectiveness and cost-effectiveness of transition clinics/programs.

Main Results:

• Few transition programs have undergone thorough evaluation; effectiveness studies often rely on historical controls.
• Transition clinics for neurological disorders are described but lack evaluation.
• Limited but suggestive evidence from diabetes, renal transplant, and rheumatologic studies indicates the value of transition clinics.
• Some studies suggest transition clinics are cost-effective, with reduced adult care costs recouping initial expenses.

Conclusions:

• More research is urgently needed to define and evaluate optimal transition programs for youth with chronic conditions.
• Transition clinics show potential for cost-effectiveness, but robust evidence is limited.
• Standardized evaluation methods are required to assess the true impact of transition interventions.