A Systematic Review of Interventions for the Transition to Adult Healthcare for Young People with Diabetes.

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The transition to adult healthcare is difficult for young adults with diabetes, with declining glycemic control and reduced healthcare utilization. Efforts are needed to facilitate an effective transfer of care. Our study aimed to systematically review the literature and identify studies evaluating the effectiveness of interventions designed to improve transition readiness and/or the transfer to adult care, describe their characteristics and outcomes, and identify areas for future research. Twenty-six studies were included with one randomized control trial and many pre-post studies observing the impact of transition programs. Generally, interventions had no clear benefit on metabolic outcomes, with variable improvement in care satisfaction and transition readiness. Studies often did not satisfy quality metrics, report important contextual factors (e.g. race, ethnicity) or involve family members. The current literature on interventions to improve transition readiness and transfer of care outcomes in young adults with diabetes is relatively limited with few studies applying rigorous methods. Future studies should apply formal methodology, include both medical and psychosocial outcomes and account for patient and health system context.