Chronic pediatric diseases into adulthood and the challenge of adolescence.

One of the priorities of public health is to improve the equity of access to a continuous interdisciplinary medical and social survey of patients with chronic complex conditions, and, notably, the switch from pediatric to adult-oriented healthcare, including the specific issues of adolescence. In spite of the many barriers related to the patients, their family, pediatricians, and even adult health providers, the concept of a planned, dynamic, multidisciplinary transition program has to be designed around the adolescent with the aim of reinforcing his autonomy, coordinating medical care, and addressing his educational/professional and psychosocial needs. The primary care physician is the pivot of adult heathcare, and should have a close relationship with the private or hospital referent specialist and paramedical structures. A key worker may make an important contribution to the coordination, the registration, and the follow-up of some cohorts.