The experiences and impact of transition from child to adult healthcare services for young people with Type 1 diabetes: a systematic review

TY - JOUR

T1 - The experiences and impact of transition from child to adult healthcare services for young people with Type 1 diabetes

T2 - a systematic review

AU - Sheehan, A. M.

AU - While, A. E.

AU - Coyne, I.

PY - 2015/4

Y1 - 2015/4

N2 - Introduction: Despite the transition between child and adult services for young people with Type1 diabetes mellitus being a high-risk period, little is known about the impact of healthcare transition upon young people.Methods: A systematic review was conducted using PubMed, PsycINFO, CINAHL and EMBASE. Papers published between January 2001 and June 2014 that examined the impact or experiences of healthcare transition in young people with Type1 diabetes were included. Data were extracted by two independent reviewers and integrated by narrative synthesis.Results: A total of 8990 citations were reviewed and 43 studies were included in the review, 24 of which explored the impact of transition and 24 examined experiences of transition. There were mixed results in terms of the change in glycaemic control and diabetes-related hospitalizations, but all studies assessing attendance found worse attendance post-transition. Data regarding experiences reported that young people and parents experienced greater difficulty in accessing and maintaining diabetes health care. Young people were required to develop independent self-management and self-advocacy skills to navigate the transition and adult health care, but some were inadequately prepared for this.Conclusions: Although the impact of healthcare transition on outcomes for young people with Type1 diabetes is unclear due to the paucity of high-quality studies, transition appears to be associated with decreased clinic attendance. There is some preliminary evidence of a positive impact of structured transition programmes. Experiences of healthcare transition illuminate the barriers to smooth transitions and the need for better integration and continuity of care.

AB - Introduction: Despite the transition between child and adult services for young people with Type1 diabetes mellitus being a high-risk period, little is known about the impact of healthcare transition upon young people.Methods: A systematic review was conducted using PubMed, PsycINFO, CINAHL and EMBASE. Papers published between January 2001 and June 2014 that examined the impact or experiences of healthcare transition in young people with Type1 diabetes were included. Data were extracted by two independent reviewers and integrated by narrative synthesis.Results: A total of 8990 citations were reviewed and 43 studies were included in the review, 24 of which explored the impact of transition and 24 examined experiences of transition. There were mixed results in terms of the change in glycaemic control and diabetes-related hospitalizations, but all studies assessing attendance found worse attendance post-transition. Data regarding experiences reported that young people and parents experienced greater difficulty in accessing and maintaining diabetes health care. Young people were required to develop independent self-management and self-advocacy skills to navigate the transition and adult health care, but some were inadequately prepared for this.Conclusions: Although the impact of healthcare transition on outcomes for young people with Type1 diabetes is unclear due to the paucity of high-quality studies, transition appears to be associated with decreased clinic attendance. There is some preliminary evidence of a positive impact of structured transition programmes. Experiences of healthcare transition illuminate the barriers to smooth transitions and the need for better integration and continuity of care.

KW - METABOLIC-CONTROL

KW - GLYCEMIC CONTROL

KW - ADOLESCENTS

KW - YOUTH

KW - MELLITUS

KW - PARENTS

U2 - 10.1111/dme.12639

DO - 10.1111/dme.12639

M3 - Article

SN - 0742-3071

VL - 32

SP - 440

EP - 458

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 4

ER -