K Minden1, M Niewerth, S Müther. 1. Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin und Universitätskinderklinik Charité, Campus Virchow; SPZ, Charitéplatz 1, 10117, Berlin, Deutschland, minden@drfz.de.
Abstract
BACKGROUND: Transition is a crucial bridge between pediatric and adult rheumatology care and yet is often not a priority in either discipline. There is adequate evidence for the need of specific transition services. Various measures and transition programs have been proposed to support care during transition to adulthood; however, the implementation of youth-friendly services including transitional care has been frustratingly slow. Many structural and psychosocial barriers exist and prevent the widespread implementation of health transition support. Transition is resource consuming. It requires a reorganization of work flow to accommodate a clear, well-documented transitional pathway, including sufficiently long consultation times, age-appropriate communication, addressing of age-specific topics and a close cooperation between pediatric and adult rheumatologists. OBJECTIVES: This article presents the Berlin transition program (BTP) and its development. RESULTS AND PERSPECTIVES: The BTP presented here is the first structured transition program financed by statutory health insurances in Germany. Since January 2013 it can be used for patients with rheumatic and musculoskeletal diseases in some regions of Germany. The BTP supports care at transfer; however, it cannot guarantee a successful transition. There is a need to make the BTP available nationwide and to evaluate its effectiveness. This could be a precondition to recognize transition services as part of regular healthcare.
BACKGROUND: Transition is a crucial bridge between pediatric and adult rheumatology care and yet is often not a priority in either discipline. There is adequate evidence for the need of specific transition services. Various measures and transition programs have been proposed to support care during transition to adulthood; however, the implementation of youth-friendly services including transitional care has been frustratingly slow. Many structural and psychosocial barriers exist and prevent the widespread implementation of health transition support. Transition is resource consuming. It requires a reorganization of work flow to accommodate a clear, well-documented transitional pathway, including sufficiently long consultation times, age-appropriate communication, addressing of age-specific topics and a close cooperation between pediatric and adult rheumatologists. OBJECTIVES: This article presents the Berlin transition program (BTP) and its development. RESULTS AND PERSPECTIVES: The BTP presented here is the first structured transition program financed by statutory health insurances in Germany. Since January 2013 it can be used for patients with rheumatic and musculoskeletal diseases in some regions of Germany. The BTP supports care at transfer; however, it cannot guarantee a successful transition. There is a need to make the BTP available nationwide and to evaluate its effectiveness. This could be a precondition to recognize transition services as part of regular healthcare.
Authors: Deborah Hilderson; Rene Westhovens; Carine Wouters; Kristien Van der Elst; Eva Goossens; Philip Moons Journal: BMJ Open Date: 2013-12-02 Impact factor: 2.692