890-P: If We Build It, Will They Come? Engagement Data from a Young Adult Diabetes Transition Clinic

Abstract

Objectives: Transition from pediatric to adult health care for young adults with type 1 diabetes has been notably concerning for patients and professionals alike. The Young Adult Diabetes Clinic (YADC) model—part of a larger transition program effort called Movin’ Up, Movin’ On, was developed to improve engagement with young adults in the transition process. Method: The multidisciplinary clinic occurs on a half day, once a month. The clinic features a 45-minute orientation to adult diabetes care led by a behavioral health provider, followed by a 25-minute diabetes education visit and 25-minute medical appointment. Results: Between November 2017 to December 2018, 129 young adults ages 17-25, approximately 60% male, were referred to the YADC (48 external and 52 internal referrals). Of the 129, 47 patients declined and 13 were non-responsive to the option to attend. Engagement efforts included word-of-mouth, reminding providers, and social media advertising. Common reasons for declining included conflict with work or school schedule, or clinic being too early in the morning. From the 47 who declined attendance, 28 established care independently at our clinic. Seven of the 47 patients remained in pediatrics, and 13 of these 47 patients’ provider status was unknown. Fifty-four patients scheduled and/or confirmed attendance. Approximately 44% were female, and mean hemoglobin A1C was 9.13% (76 mmol/mol). Approximately 27% were covered by state insurance while 73% had private insurance. Of the 54 scheduled, 12 patients no-showed, and 42 attended. Twenty-seven of the 54 patients both, attended YADC and established themselves as patients. Conclusions: Preliminary data are promising, in that more than 50% of the patients who agreed to attend the clinic also established ongoing clinical services. The clinic model also supported only 10% of patients being lost to follow-up compared to higher rates previously reported in the literature. These results warrant ongoing support for the YADC model. Disclosure H. Nagra: None. F. Joarder: None. L. Andreas: None. I. Guttmann-Bauman: None. K. Kraus: None. L. Rocha: None.