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The transition from pediatric to adult health care is challenging for youth with autism spectrum disorder (ASD). Many tools have been developed to facilitate transition but studies have not assessed their utility or readiness to be implemented in primary care practices. The purpose of this paper is to rate existing health care transition tools to identify tools ready for use in primary care clinics and develop a set of transition principles.

Four pediatric and family medicine providers from community health centers reviewed 12 transition tools and provided ratings and in-depth responses about the usefulness and feasibility of each tool through online surveys and telephone interviews. A conference call was used to discuss the findings and develop a set of transition principles.

The top rated tools included three youth self-management tools, two tools focused on ASD information and one tool focused on communication. No one tool was top rated by all providers and none of the tools was ready to be implemented without revisions. The transition principles developed focused on the use of selected tools to involve all youth in regular conversations about transition at every well child visit beginning at age 14 and adapting that process for youth with special needs.

This study is unique in asking primary care providers to assess the applicability of incorporating existing and publicly available transition tools in their own practices and developing a set of transition principles.

Effective transitions from child and adolescent to adult services are important for continuity of care for patients with eating disorders. This study aims to examine the relative importance of a series of statements about the transition process, elicited from an earlier service evaluation, from the perspectives of patients, parents/carers and clinicians.

Twenty-eight participants completed a Q-sort task ranking 40 statements, developed from an earlier study, using a normal distribution pattern on a scale, which ranged from strongly agree to strongly disagree, to identify their priorities for transition. Analysis resulted in the extraction of four factors explaining 52% of the variance.

Four distinct factors were elicited: “parents and carers need including too”, “facilitating effective transfer between services”, “supporting the patient through transition” and providing “timely, patient-centred care”. The study enabled similarities and differences in priorities to be observed for the three respondent groups.

These rankings, noting the differences between the respondent groups, can be used to inform the development of effective transition protocols. This study suggests these protocols should ensure a person-centred approach; timely planning; include parents/carers; provide continuous care and have good transfer of information and sensible timing of transitions. Differences in priorities/opinions can be addressed through open communication channels.

To the best of the authors’ knowledge, this is the first UK-wide study examining priorities for transition from the perspectives of patients, parents/carers and clinicians.

Adults with autism spectrum disorder (ASD) experience significant health-care disparities across physical and mental health domains resulting in poorer health and quality of life. Poor transitions to adult care negatively impact the health of adults with ASD. Current research focuses on personal factors in research samples that lack diversity. The purpose of this study is to examine the lived health-care experiences of geographically and ethnically diverse young adults with ASD in adult care settings in the USA to understand provider and system-level factors affecting their health.

Nine caregivers of young adults with ASD participated in key informant interviews describing their experiences in navigating the health-care system. Data were analyzed using a grounded theory approach.

The data indicated that limited quantity of services, poor quality of services, and high cost of services had a negative effect on the health of adults with ASD. Issues cascaded to become more complex.

Practical implications for payors, providers, persons with ASD and their families are discussed in this paper.

To the best of the authors’ knowledge, this study answers the call to better understand system-level factors affecting the health of geographically and ethnically diverse people with ASD.

There is substantial evidence that young people moving from child and adolescent mental health services to adult services are more likely to experience poor transitions. However, little is known about the care pathways of young people transitioning from forensic services. This retrospective case note review sought to examine the clinical characteristics, transition pathways and psychosocial indicators of transition outcomes amongst young people in forensic medium secure services discharged to adult services.

The electronic records of 32 young people, who transitioned from six adolescent medium secure units in England to adult services between May 2015 and June 2016, were examined.

Approximately 65% of young people were between 18 and 19 years at the time of transition and the average waiting time from referral to discharge was six months. A total of 63% young people transitioned to community placements and adult medium secure services. Four pathways describing the journey into and out of adolescent medium secure services were identified in a subsample of 12 young people. A total of 25% young people with neurodevelopmental problems moved to specialist services.

The results suggest that diagnosis, severity of offence and clinical background are associated with transition pathway. Promoting a person-centred approach and gradual independence of the young person may improve current practice.

These results inform existing policy and clinical practice in an effort to reform transition guidelines around young people’s needs during transition times. Further studies in adolescent forensic services are needed to understand complex neurodevelopmental problems and comorbidities.

ADHD is the commonest neurodevelopmental disorder of children and adolescents. ADHD is no longer conceptualized as a predominantly childhood disorder but is a chronic disorder that persists into adolescence and adulthood. The paper aims to analyse the transitional care of adolescents diagnosed with ADHD in childhood into adult specialist ADHD services in a local district. The paper also seeks to review current practice and to design a multi‐disciplinary transitional care pathway to adult services for adolescents with complex health needs based on best practice and available clinical guidelines.

Adolescents diagnosed with ADHD from childhood who were eligible for transition to adult ADHD services and who reached the age of 16 years over a period of two years consecutively (July 2009 to June 2011) were studied by a retrospective analysis of their clinical records. The current transitional care pathway was reviewed and revised.

Out of 504 patients on the specialist ADHD database, 104 adolescents were eligible for transition to adult services. A total of 19 patients (18 per cent) were referred to CAMHS. A total of 68 adolescents (65 per cent) were discharged from the paediatric services following voluntary discontinuation of medications and non‐attendance at follow‐up clinics. Only 16 patients (15 per cent) were successfully referred to the specialist adult ADHD services (three of them already discharged). A multi‐disciplinary transitional care pathway to adult services for young people with complex health needs and learning difficulties and information for the carers and young people have been designed and adopted in the local city borough, agreed by all the stakeholders.

A total of 73 per cent of eligible patients were either discharged or lost to follow‐up. There must be some flexibility in the referral pathway to the adult ADHD services to allow some of the adolescents who were previously lost to follow‐up to be re‐referred by other primary or secondary care healthcare professionals if the need arises in the future.

The paper shows that there is a high rate of discontinuation of medications, loss to follow‐up and a remarkably low rate of successful transition to locally commissioned adult ADHD services among adolescents diagnosed with ADHD in childhood.

Drawing on the experiences of healthcare professionals in one paediatric hospital, this paper explores the influence of context and organisational behaviour on the implementation of a person-centred transition programme for adolescents and young adults (AYA) with long-term conditions.

A single embedded qualitative case study design informed by a realist evaluation framework, was used. Participants who had experience of implementing the transition programme were recruited from across seven individual services within the healthcare organisation. The data were gathered through semi-structured interviews (n = 20) and analysed using thematic analysis.

Implementation of the transition programme was influenced by the complex interaction of macro, meso and micro processes and contexts. Features of organisational behaviour including routines and habits, culture, organisational readiness for change and professional relationships shaped professional decision-making around programme implementation.

There exists a significant body of research relating to the role of context and its influence on the successful implementation of complex healthcare interventions. However, within the area of healthcare transition there is little published evidence on the role that organisational behaviour and contextual factors play in influencing transition programme implementation. This paper provides an in-depth understanding of how organisational behaviour and contextual factors affect transition programme implementation.

This study aims to investigate whether factors previously shown to influence attendance rates for appointments in general practice and general mental health services also influence attendance rates in services for people with intellectual disabilities (ID).

Post hoc data from 452 psychology appointments, ID diagnostic and initial screening (triage) appointments were collected from the health-care files of a community adult ID psychology service. Demographic factors (age, sex) and clinical factors (waiting time, time between appointment invitation being sent and appointment being held, presence of prior telephone call or letter, type of appointment, weekday, month) were recorded along with the attendance outcome (attended/did not attend [DNA]). The impact of the COVID-19 pandemic was also explored by documenting whether the appointment predated March 2020.

No significant associations were found between any variable investigated and attendance outcome when analysing appointment data as a whole and when splitting the data between appointment type. Weekday was found to significantly be associated with attendance outcome for appointments held during COVID-19, in which more DNA appointments occurred on a Wednesday compared to the other days of the week. No other associations were found for appointments held during the COVID-19 pandemic or for appointments held prior to the COVID-19 pandemic. These results suggest that factors which influence attendance rates in general health-care settings do not necessarily generalise to ID services.

To the best of the authors’ knowledge, this study is the first to examine whether certain demographic and clinical factors influenced attendance rates in an adult intellectual disability service.

Digital mental health interventions (DMHIs) are promising alternatives to traditional face-to-face psychological interventions to improve psychological outcomes in various chronic health conditions. However, their efficacy among people with diabetes is yet to be established. Therefore, this narrative review aims to identify the importance and need for evidence-based research on DMHIs targeting the psychological outcomes in people with diabetes.

Using a narrative review approach, this study highlights the technological advancements in diabetes health care and identifies a need for developing DMHIs for people with diabetes.

DMHIs are promising for improving psychological outcomes in people with diabetes. However, there is a need for further rigorous, controlled and high-quality diabetes-focused studies, to make firm conclusions on the effectiveness and appropriateness of DMHIs for patients with diabetes. This review also suggests that DMHIs based on psychological theories and studies with higher quality methodologies are also needed.

This review highlights the contemporary literature on diabetes and related technological advancements. The findings of this study serve as a basis of the improvement of policy on digital mental health services for people with diabetes, to impact the global burden of the disease.

This study examined access to and quality of supports for families of adolescents with disabilities.

An online survey was completed by family members of transition-aged young adults who had participated in parent training sessions on topics related to transitions to adulthood. Survey responses came from all 50 states, the District of Columbia, and 4 U.S. territories.

More than one-third of families reported unmet information needs related to areas such as employment, housing, preparing for adult relationships, and preparing others to support the family members with disabilities. Families of younger transition-aged youth, youth with Autism Spectrum Disorder or other disabilities, and families with lower household incomes reported more unmet needs. The overall quality of services families reported receiving was 2.19 on a 4-point scale of 1 to 4. Parents reported needing more information and quality of supports related to the transition of youth from school to adulthood.

Given the scope of unmet needs, ongoing collaboration between schools, agencies, organizations, and other entities that serve families is critical. While schools play a key role in supporting the transition process, other organizations also have a role.

The results from this survey demonstrate that the need for support is not limited to youth with disabilities, but that family members also have information and support needs related to their roles as caregivers in the transition process.

This survey provides information about unmet needs and current services from a national sample that includes often underserved populations and includes sufficient numbers of respondents to allow comparisons between families, based on the type of disability their family member had.

There is a dearth of research on what constitutes effective transfer of care from children’s and young people services to adult services for patients with eating disorders (EDs) in the UK. Transition has implications for continuity of care and particularly for early intervention which has the best prognosis. The purpose of this paper is to understand the experience of transition and identify facilitators and barriers to this.

Qualitative methodology was used. Focus groups (n = 4) were held with clinicians (n = 22) working in Child and Adolescent Mental Health Services or adult ED services. Individual interviews were conducted with patients (n = 5) who had commenced/completed transition to adult services and with parents/carers (n = 6) of patients invited for interview.

A number of factors may facilitate or impede transition and can be grouped into the broad themes of communication, managing the differences between services and timing of transition. Improvements in communication, clear explanation of service differences and flexibility around the timing of transitions may enhance the experience for patients and parents/carers.

The service evaluation was limited to transition between two specialist ED services in one geographical location. The findings provide the basis for a wider research study to examine which factors are most important when planning transition from the perspectives of patients, parents/carers and clinicians.

This is the first study examining ED transitions in the UK. It provides valuable insight of the experience of service users and carers and highlights potential improvements when planning transitions for this patient group.