A review of the Endocrine Transition Service over the last 10 years
Nilanjana Ray1, Tania Davison1, Fiona Ryan1, John Wass2 & Niki Karavitaki2
Poor transitional care leads to increased loss to follow up, non-adherence to treatment, high morbidity and mortality. The paediatric and adult endocrinology teams in our Trust have been running a joint transition service since 10/2000. A review of this service was undertaken, in order to examine its effectiveness and to aid its improvement.
The details of all 81 patients, who had been through transitional care between 10/00-09/09 were acquired. Their records were reviewed for relevant information. A questionnaire and covering letter were sent to survey patient satisfaction and their views on their transition process.
The mean age of transition was 18.6 years. Currently, 34 out of 77 (44%) patients have replied to the questionnaire (4 had died). 79% felt that the timing of transition was appropriate, 100% that it was helpful to meet the adult endocrinologist prior to transfer and 12% that they would prefer two transition clinic appointments. 76% reported that they were given enough information about their condition and the transition process and 53% that they felt confident to be seen without their parents present in 1st or 2nd appointment in the adult clinic. The mortality rate was 5%, 4% of the patients had been admitted acutely within 2 years of transition and 11% had issues with adherance to treatment. The DNA rate at the second adult follow-up appointment was 16% (for general adult endocrine clinics 610%).
Overall, the patient satisfaction with the service is high. Providing written information about the transition process and the conditions affecting the patients and addressing compliance issues will further improve it. Generation of national guidelines on endocrine transition care is of major importance for the continuing wellbeing of the patients and their willingness to take responsibility of their own health and to comply with health support and treatment.