In 2002, the AAP published a consensus statement that stressed the importance of pediatricians needing to help adolescents and young adults transition from a pediatric medical home to one focused on the care of adults. Since then there have been a number of articles and editorials reinforcing the importance of a smooth and seamless transition of care, including some in our own journal. So a decade and a half later, how are we doing? To answer that question, Lebrun-Harris et al. (10.1542/peds.2018-0194) provide us with data from the 2016 National Survey of Children’s Health involving 20,708 teens between 12 and 17 years, some with special health care needs and some without. Parents and caregivers were surveyed to see if transition of care had been discussed and if actual planning had ensued involving any of the following components: (1) a health care provider discussed with the teenager and caregiver the need to shift to an adult provider; (2) the provider worked with the teen to gain self-care skills or understand the need to change providers as they got older; and (3) time spent with the provider and teen alone focused on transitioning of care. While one or more component occurred from 40-69% of the time, only 17% of the youth with special health care needs and 14% of those without special health care needs receiving all three, which together are considered by the authors key for a successful transition.
Why is comprehensive transition so unlikely to occur? To help answer that question, we asked Dr. Megumi Okumura from UCSF to share with us a commentary (10.1542/peds.2018-2245) focused on what we can do to strengthen transitioning for all children. There is an enormous amount of interesting and provocative findings in this study, so transition from this blog over to the study and commentary and then reflect on what more you can be doing to strengthen the steps needed for successful transition of your adolescent patients to an adult clinician.