O-008 Transition Readiness in Adolescents/Young Adults Approaching Transfer to Adult Care

Abstract

Almost 80% of adult gastroenterologists report inadequacies in the preparation of patients transferred from pediatrics. Poorly managed transition results in treatment non-adherence, increased disease severity, and undue stress for patients, families, and health care providers. In order to prevent these outcomes and improve transition to adult care in IBD, it is important to identify the specific deficits in IBD management that pediatric patients are demonstrating prior to their transfer to adult care. The current study examines transition readiness skill acquisition in adolescents and young adults on the verge of transfer to adult care and identifies specific gaps in transition readiness that should be addressed prior to transfer. Older adolescents and young adults (ages 16–25) in pediatric gastroenterology clinics in the Midwestern United States completed the Transition Readiness Assessment Questionnaire, Version 5 (TRAQ) as part of their routine medical care. This 20-item measure examines the mastery of skills essential to successful transition to adult care among youth with special healthcare needs. Based on prior work by an interdisciplinary, multi-institutional Transition Task Force, 90% mastery of TRAQ skills was considered a benchmark of transition readiness. 145 adolescents/young adults (M = 18.08 ± 1.86 years; 56.6% male) completed the TRAQ. Data suggest that only 8 out of 145 patients (5.5%) on the verge of transfer to adult care are meeting institutional benchmarks for transition readiness (i.e., 90% mastery of readiness skills). On average, patients report mastery of 9 out of 20 skills (M = 9.08 ± 4.83). Although a higher percentage of patients who are aged 18 years and over (N = 83) are meeting institutional benchmarks (7.2%), most adolescents and young adults demonstrate significant gaps in their transition readiness. Specific deficits were noted in the areas of self-management (e.g., obtaining and refilling prescriptions, proactive communication with providers) and self-advocacy/health care utilization (e.g., arranging and following up on needed IBD care, knowledge of health insurance coverage). Most patients on the verge of transferring to adult care are not meeting established benchmarks of transition readiness, indicating a critical need for additional intervention and support. The significant and specific deficits in transition readiness skills observed are all modifiable behaviors that can be targeted as part of a comprehensive IBD care program. Using objective benchmarks to routinely assess readiness skills may be an opportunity to quickly identify and address these deficits and enhance transition readiness. Addressing these deficits in pediatric care may minimize the retention of young adult patients in this setting and enhance the ability of adult gastroenterologists to provide the best possible care for their newly transferred patients.