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Need and Feasibility of a Transition Clinic for Adolescents with Chronic Illness: A Qualitative Study

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Abstract

Objective

To assess the need and feasibility of a Transition Clinic in the care of adolescents with chronic illness.

Methods

A qualitative study, piloted by a questionnaire-based survey, followed by Focus Group Discussions was conducted in the Department of Pediatrics in a government teaching hospital in Kerala. The participants were adolescents with chronic disease, viz., renal disease, diabetes, HIV/AIDS, cancer survivors with Hepatitis B, parents of renal patients, pediatricians and adult specialists. Twenty patients were administered a structured, rated, 18-item questionnaire regarding their attitude and preparedness for transfer to adult departments. The need and feasibility of a Transition Clinic was discussed by 7 focus groups viz., pediatricians, adult physicians, 4 patient groups and 1 parent group. Thematic analysis of data was done.

Results

Except among pediatricians, awareness of the concept of Transition Clinic was low. All participants agreed that abrupt transfer of care hinders treatment and that there is a definite need for a Transition Clinic. Pediatricians discussed the complex needs of adolescents and limitations of their care. Adult specialist physicians described their inadequacy to handle adolescent problems and difficulties posed by large volumes of patients. The adolescents and young adults with chronic illness discussed their reluctance to shift to the adult departments. Parents voiced their concerns about the future of their children. All groups gave constructive suggestions for conduct of the clinic and smooth transition.

Conclusions

There is a definite need for a Transition Clinic in the management of adolescents with chronic illness to ensure smooth transfer of care. Introducing such clinics in the existing health framework is feasible using a multidisciplinary approach.

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References

  1. White PH. Access to health care: health insurance considerations for young adults with special health care needs/disabilities. Pediatrics. 2002;110:1328–35.

    PubMed  Google Scholar 

  2. Gurvitz M, Inkelas M, Lee M, Stout K, Escarce J, Chang R. Changes in hospitalization patterns among patients with congenital heart disease during the transition from adolescence to adulthood. J Am Coll Cardiol. 2007;49:875–82.

    Article  Google Scholar 

  3. Hennink MM. Designing and conducting focus group research. Focus Group Discussions (Understanding Qualitative Research). New York: Oxford University Press. 2014. p. 35–95.

  4. Blum RW, Garell D, Hodgman CH. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health. 1993;14:570–6.

    Article  CAS  Google Scholar 

  5. American Academy of Pediatrics. American Association of Family Physicians, American College of Physicians: a consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110:1304–6.

    Google Scholar 

  6. Rosen DS, Blum RW, Britto M, Sawyer SM, Siegel DM. Society for Adolescent Medicine. Transition to adult health care for adolescents and young adults with chronic conditions: position paper of the Society for Adolescent Medicine. J Adolesc Health. 2003;33:309–11.

    Article  Google Scholar 

  7. Watson AR, Harden P, Ferris M, Kerr PG, Mahan J, Ramzy MF. Transition from pediatric to adult renal services: a consensus statement by the International Society of Nephrology (ISN) and the International Pediatric Nephrology Association (IPNA). Pediatr Nephrol. 2011;26:1753–7.

  8. Viner R. Transition from pediatric to adult care. Bridging the gaps or passing the buck? Arch Dis Child. 1999;81:271–5.

    Article  CAS  Google Scholar 

  9. Tuchman LK, Slap GB, Britto MT. Transition to adult care: experiences and expectations of adolescents with a chronic illness. Child Care Health Dev. 2008;34:557–63.

    Article  CAS  Google Scholar 

  10. Kakkar F, Van der Linden D, Valois S, et al. Health outcomes and the transition experience of HIV-infected adolescents after transfer to adult care in Québec, Canada. BMC Pediatr. 2016;16:109.

  11. Nakhla M, Daneman D, To T, Paradis G, Guttmann A. Transition to adult care for youths with diabetes mellitus: findings from a universal health care system. Pediatrics. 2009;124:e1134–41.

    Article  Google Scholar 

  12. Prestidge C, Romann A, Djurdjev O, Matsuda-Abedini M. Utility and cost of a renal transplant transition clinic. Pediatr Nephrol. 2012;27:295–302.

    Article  Google Scholar 

  13. Ramadass S, Gupta SK, Nongkynrih B. Adolescent health in urban India. J Family Med Prim Care. 2017;6:468–76.

    Article  CAS  Google Scholar 

  14. Salins NS, Vallath N, Varkey P, Ranganath K, Nayak MG. Clinical audit on “evaluation of special issues in adolescents with cancer treated in an adult cancer setting”. An Indian experience. Indian J Palliat Care. 2012;18:196–201.

    Article  Google Scholar 

  15. Rashtriya Kishor Swasthya Karyakram (RKSK) | National Health Portal of India. Available at: http://www.nhp.gov.in/rashtriya-kishor-swasthya-karyakram-rksk_pg. Accessed 18 June 2019.

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Acknowledgements

The authors express their deep gratitude to the patients, their parents and the doctors who gave their valuable time and made the effort to participate in the discussions.

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Authors and Affiliations

  1. Department of Pediatrics, Government Medical College, Thrissur, Kerala, India

    Janaki Menon, Anu Marie Peter, Lathika Nayar & Anugraha Kannankulangara

Authors
  1. Janaki Menon
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  2. Anu Marie Peter
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  3. Lathika Nayar
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  4. Anugraha Kannankulangara
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Contributions

JM was involved with concept and design of the study, conduct of the pilot study and the focus group discussion (FGD), with drafting the manuscript, critical revision and final approval and will act as guarantor; AMP was involved with concept and design of the study, conduct of the FGD, data collection, drafting and revising the manuscript; LN was involved with the design of the pilot study, data collection and revising and editing the manuscript; AK was involved with concept and design of the study, data collection, assisted in conduct of the pilot study and FGD.

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Correspondence to Janaki Menon.

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Menon, J., Peter, A.M., Nayar, L. et al. Need and Feasibility of a Transition Clinic for Adolescents with Chronic Illness: A Qualitative Study. Indian J Pediatr 87, 421–426 (2020). https://doi.org/10.1007/s12098-020-03189-z

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  • DOI: https://doi.org/10.1007/s12098-020-03189-z

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