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Transition in endocrinology: predictors of drop-out of a heterogeneous population on a long-term follow-up

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Abstract

Purpose

To evaluate: (1) clinical and epidemiological characteristics of outpatients transitioned from Pediatrics Endocrine (PED) to Adult Endocrine Department (AED) in a tertiary center; (2) transition process features, and predictors of drop-out.

Methods

Demographic, clinical, and transition features of 170 consecutive patients with pediatric onset of chronic endocrine or metabolic disease (excluded type 1 diabetes) who transitioned from PED to AED (2007–2020) were retrospective evaluated.

Results

The age at transition was 18.4 ± 4 years (F:M = 1.2: 1), and mean follow-up 2.8 years. The population was heterogeneous; the most (69.4%) was affected by one, 24.1% by two or more endocrine diseases, 6.5% were followed as part of a cancer survivor’s surveillance protocol. The comorbidity burden was high (37, 20.6, and 11.2% of patients had 2, 3, 4, or more diseases). The number of visits was associated with the number of endocrine diseases and the type of them. Adherent subjects had a higher number of comorbidities. Thyroid disorders and more than one comorbidity predicted the adherence to follow-up. Having performed one visit only was predictive of drop-out, regardless of the pathology at diagnosis.

Conclusion

This is the first study that analyzed a specific transition plan for chronic endocrine diseases on long-term follow-up. The proposed “one-size-fits-all model” is inadequate in responding to the needs of patients. A structured transition plan is an emerging cornerstone.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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Authors and Affiliations

  1. Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy

    F. Prodam, M. Caputo, M. Romanisio, S. Brasili, M. Zavattaro, M. T. Samà, A. Ferrero, S. Costelli & G. Aimaretti

  2. Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy

    F. Prodam & M. Caputo

  3. Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis 15, 00135, Rome, Italy

    F. R. Lenzi

  4. Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy

    A. Petri, E. Basso & S. Bellone

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  1. F. Prodam
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Correspondence to F. Prodam.

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Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the local ethical committee (“Maggiore della Carità” Hospital, Novara).

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Prodam, F., Caputo, M., Romanisio, M. et al. Transition in endocrinology: predictors of drop-out of a heterogeneous population on a long-term follow-up. J Endocrinol Invest 46, 1009–1016 (2023). https://doi.org/10.1007/s40618-022-01975-4

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  • DOI: https://doi.org/10.1007/s40618-022-01975-4

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