9-Year Evaluation of a Transitional Care Program for Congenital Neurogenic Bladder Patients

Area of Science:

• Urology
• Pediatric Urology
• Adolescent Medicine

Background:

• Effective transition from pediatric to adult care is crucial for patients with congenital neurogenic bladder.
• Established transition clinics aim to improve continuity of care and adherence during this critical phase.
• Understanding adherence patterns and influencing factors is essential for optimizing transition processes.

Purpose of the Study:

• To evaluate short- and long-term adherence and nonadherence in a staged transition clinic for congenital neurogenic bladder patients.
• To compare adherence outcomes between patients utilizing a structured transition clinic and those self-initiating adult care.
• To identify factors influencing the success of the transition clinic.

Main Methods:

• Retrospective chart review of congenital neurogenic bladder patients managed through a transition clinic since 2014.
• Analysis of demographic and clinical data to assess adherence to transfer of care and long-term follow-up.
• Identification of factors positively and negatively impacting transition clinic success.

Main Results:

• 96.2% of patients ready for transition successfully transferred to adult care, with 72.4% remaining active.
• A greater number of visits between transition stages correlated with sustained active follow-up (P=.006).
• Formally transitioned patients demonstrated significantly higher yearly participation rates (72.4%) compared to non-transitioned patients (36.8%, P<.001).

Conclusions:

• A structured transition clinic facilitates successful transfer and improves long-term adherence for congenital neurogenic bladder patients.
• Early introduction to adult providers and increased visit frequency positively influence adherence.
• Noncompliance with pediatric care negatively impacts transition adherence.