Antoine Rachas1, Delphine Lefeuvre2, Laurence Meyer3, Albert Faye4, Nizar Mahlaoui5, Elise de La Rochebrochard6, Josiane Warszawski3, Pierre Durieux7. 1. Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Department of Epidemiology and Public Health, Paris-Sud University Hospital, and Paris Sud University, Le Kremlin-Bicêtre, France; antoine.rachas@inserm.fr. 2. Department of Social Epidemiology, INSERM, Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; 3. Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Department of Epidemiology and Public Health, Paris-Sud University Hospital, and Paris Sud University, Le Kremlin-Bicêtre, France; 4. General Pediatrics, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris 7 Denis Diderot University, Sorbonne Paris Cité, Paris, France; INSERM UMR 1123, Paris, France; 5. French National Reference Center for Primary Immune Deficiencies, and Pediatric Immuno-Hematology and Rheumatology Unit, Necker Enfants Malades University Hospital, and INSERM UMR 1163, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; 6. Center for Research in Epidemiology and Population Health, UMR 1018, INSERM, Paris-Sud University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France; Institut National d'Etudes Démographiques, Paris, France; 7. Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Informatics and Public Health, Georges Pompidou European Hospital, Paris, France; and INSERM Cordeliers Research Center UMRS 872, Paris Descartes University, Paris, France.
Abstract
CONTEXT: Appropriate outcomes are required to evaluate transition programs' ability to maintain care continuity during the transfer to adult care of youths with a chronic condition. OBJECTIVE: To identify the outcomes used to measure care continuity during transfer, and to analyze current evidence regarding the efficacy of transition programs. DATA SOURCES: PubMed (1948-2014), Web of Science (1945-2014), Embase (1947-2014), and the reference lists of the studies identified. STUDY SELECTION: Screening on titles and abstracts; full-text assessment by 2 reviewers independently. DATA EXTRACTION: By 2 reviewers independently, by using a Cochrane form adapted to observational studies, including bias assessment. RESULTS: Among the 23 studies retrieved, all but 5 were monocentric, 16 were cohorts (15 retrospective), 6 cross-sectional studies, and 1 randomized trial. The principal disease studied was diabetes (n = 11). We identified 24 indicators relating to 2 main aspects of continuity of care: engagement and retention in adult care. As designed, most studies probably overestimated engagement. A lack of adjustment for confounding factors was the main limitation of the few studies evaluating the efficacy of transition programs. LIMITATIONS: The assessment of bias was challenging, due to the heterogeneity and observational nature of the studies. CONCLUSIONS: This review highlights the paucity of knowledge about the efficacy of transition programs for ensuring care continuity during the transfer from pediatric to adult care. The outcomes identified are relevant and not specific to a disease. However, the prospective follow-up of patients initially recruited in pediatric care should be encouraged to limit an overestimation of care continuity.
CONTEXT: Appropriate outcomes are required to evaluate transition programs' ability to maintain care continuity during the transfer to adult care of youths with a chronic condition. OBJECTIVE: To identify the outcomes used to measure care continuity during transfer, and to analyze current evidence regarding the efficacy of transition programs. DATA SOURCES: PubMed (1948-2014), Web of Science (1945-2014), Embase (1947-2014), and the reference lists of the studies identified. STUDY SELECTION: Screening on titles and abstracts; full-text assessment by 2 reviewers independently. DATA EXTRACTION: By 2 reviewers independently, by using a Cochrane form adapted to observational studies, including bias assessment. RESULTS: Among the 23 studies retrieved, all but 5 were monocentric, 16 were cohorts (15 retrospective), 6 cross-sectional studies, and 1 randomized trial. The principal disease studied was diabetes (n = 11). We identified 24 indicators relating to 2 main aspects of continuity of care: engagement and retention in adult care. As designed, most studies probably overestimated engagement. A lack of adjustment for confounding factors was the main limitation of the few studies evaluating the efficacy of transition programs. LIMITATIONS: The assessment of bias was challenging, due to the heterogeneity and observational nature of the studies. CONCLUSIONS: This review highlights the paucity of knowledge about the efficacy of transition programs for ensuring care continuity during the transfer from pediatric to adult care. The outcomes identified are relevant and not specific to a disease. However, the prospective follow-up of patients initially recruited in pediatric care should be encouraged to limit an overestimation of care continuity.
Authors: Kathryn J Snow; Lisa J Nelson; Charalambos Sismanidis; Susan M Sawyer; Stephen M Graham Journal: Epidemiol Infect Date: 2018-04-15 Impact factor: 4.434
Authors: Antoine Rachas; Philippe Tuppin; Laurence Meyer; Bruno Falissard; Albert Faye; Nizar Mahlaoui; Elise de La Rochebrochard; Marie Frank; Pierre Durieux; Josiane Warszawski Journal: PLoS One Date: 2018-03-13 Impact factor: 3.240
Authors: Gertrude van den Brink; Martha A C van Gaalen; Lissy de Ridder; C Janneke van der Woude; Johanna C Escher Journal: J Crohns Colitis Date: 2019-09-19 Impact factor: 9.071