Navigating the transition: assessing continuity and loss in endocrinology care.

Abstract

Background: Transition describes preparing children with chronic illnesses for adult healthcare and gradually transferring their care, starting late adolescence. Joint meetings and visits are recommended during this process. This study examines an 8-year transition experience in our clinic, focusing on the differences between adult and pediatric endocrinology practices and the rates of loss to follow-up in specific disease groups.

Methods: Three hundred thirty-five patients evaluated in transition meetings were included. The frequency of visits 1 year before transition, during the first and second years after transition, the number of patients lost to follow-up and disease groups were analyzed.

Results: Among the patients discussed in the transition meetings, 56.3% participated in joint visits. Post-transition, 82.5% of patients continued their follow-up care, while 17.5% were lost to follow-up. There was a statistically significant difference in the number of visits before and after the first year of transition (P = 0.000).

Conclusion: To increase adaptation during the transition, informing patients and families about the process at every visit after late adolescence is beneficial. Moreover, scheduling joint visits on flexible dates and increasing the number of joint visits per patient could substantially enhance patient participation and follow-up rates. We observed that patient follow-up frequency was higher in pediatric endocrinology due to differences in pediatric and internal medicine practices.