Transitional Medicine, from Childhood to Adulthood

Abstract

Health care transition (HCT) is a very complex process that addresses the medical, psychosocial, educational, and vocational needs of adolescents and young adults with chronic medical conditions, as they advance from paediatric to adulthood age. There are still many unanswered questions regarding the proper health care provider for these patients. In particular, adult hospitals often have no experience in managing chronically ill adolescents. Adolescence is a period of life that encloses many physical and psychological changes. Their impact could be even more important in frail children with chronic ills. Health care providers need to focus on the care of the young person rather than the illness. An inadequate transition process for adolescents affected by chronic diseases is associated with a worsening of their health status. The goals of HCT are (1) to ensure an organized process in paediatric and adult health care practices; and (2) to improve the ability of youth and young adults to manage their health care and effectively use health services. As the number of young people with chronic illnesses/disabilities has increased worldwide, there is a major request for clinical studies based on long-term follow-up of frail children. Currently, most countries have no guidelines on health care transition and often the process is primarily organized in local settings. In conclusion, the transition from paediatric to adult health care represents a critical time for youth with chronic conditions and/or developmental disabilities. Future efforts to improve available resources and provider preparedness are required to meet the complex needs of frail patients.