PMU117 IN BETWEEN TWO WORLDS: PATIENT EXPERIENCES IN THE TRANSITION FROM ADOLESCENT TO YOUNG ADULT HEALTHCARE SERVICES AND IMPLICATIONS FOR HEALTH OUTCOMES ASSESSMENT

Abstract

Adolescents (10-17 years) and young adults (18-25 years) make up approximately 24% of the population worldwide. The objective of this research was to explore and summarize the barriers to and facilitators of successful transition from adolescent to young adult healthcare services, and possible implications for health outcomes assessment. A targeted systematic search of published review articles over the past 10 years was performed in Medline via PubMed, followed by a grey literature search. Publications were included if they described the experiences of patients transitioning from adolescent to adult healthcare services and excluded if transition was not a central focus. Selected articles were reviewed in full and barriers to (personal, relational, system) and facilitators of (plans, services, interventions) transition were documented. The PubMed search yielded 53 abstracts which were reviewed for relevance; 43 were selected for full-text review, and 23 additional articles were selected from the grey literature search. Commonly reported condition categories were: immunological (n=14); unspecified chronic conditions (n=8); HIV (n=7); hematological (n=5); cardiovascular (n=4); surgical transplants (n=4); and musculoskeletal (n=4). Articles reporting other conditions (e.g., transgender, low birthweight, psychiatric conditions) were mentioned by ≤3 articles. Findings identified barriers to healthcare transition including adolescents’ lack of confidence in their ability to communicate with providers and/or manage medication; lack of trust in new medical team; emotional/developmental issues; and inadequate preparation. Facilitators to healthcare transition included a well-planned, multidisciplinary approach; active communication between patient and adult providers; cultivating medical independence; and family/financial support. Across conditions, common barriers exist for adolescents as they transition to adult healthcare services. A well-defined plan and effective communication strategies facilitate successful transition. Clinical outcome assessments (COAs) support patient self-monitoring and -management, patient engagement, and patient-provider communications. The potential applications of COAs should be explored to support adolescents as they transition to adult healthcare services.