Background: Transitioning of children with chronic illnesses into adult services is a major challenge. The diabetes transition process in our unit was being redesigned and this audit was performed to provide a historical benchmark relating to the previous setup. During the audit period, young people had a joint appointment in the paediatric service with an adult nurse specialist and then were referred by letter to the adult diabetes team.
Aim: We collected key data from the year before and after transition which included age, number of appointments offered and attended, average HbA1c, hospital admissions and whether patients had annual review before transition.
Methods: Data from patients transitioned over 3 year period (n=46) was collected retrospectively from case notes and laboratory database.
Results: The majority of patients were transitioned at the age of 17 years. Ninety-six percent were transitioned to adult services in the same trust. The number of appointments offered per year before transition was more than after. Attendance rates in the year before and after transition were 60 and 55%. Out of 46 patients, 7 did not attend any appointments in the year after transition, 6 of them were male and most had poor glycaemic control. Three were subsequently lost to follow up. Mean HbA1c before and after transition was 9.5 and 9.8% respectively. Hospital admissions were more in the year before transition.
Conclusions: This audit provided key information around the year of transition. Glycaemic control and clinic attendance is poor around transition. Following this audit, the transition process has been redesigned. We need to particularly target young boys with poor glycaemic control to engage with services to prevent them becoming lost to follow up.
13 Nov 2013
British Society for Paediatric Endocrinology and Diabetes