ASSESSING PERCEPTIONS AND EXPERIENCES OF ADULT-CARE PROVIDERS WITH TRANSITION FROM PEDIATRIC TO ADULT MEDICAL CARE

Michael Cafarchio, MD*1;Rowan Hurrell, MD1;Leah Millstein, MD2 and Vicki Tepper, Ph.D.2, (1)University of Maryland Medical Center, Baltimore, MD, (2)University of Maryland School of Medicine, Baltimore, MD

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 243

Categories: Research Abstracts, Transitions of Care

Keywords: ,

Background: With advances in medical care, there is a growing population with childhood-onset chronic health conditions reaching adulthood. A 2011 consensus statement by the AAP, AAFP and ACP identified an algorithm for transition from pediatric to adult care, but change in practice has been slow. The purpose of this study was to better understand the perceptions and experiences of adult-care providers with transitional care at a large, academic tertiary care medical center.Methods: A 14 item anonymous survey was disseminated via email to 280 providers representing 12 divisions of Internal Medicine in May 2015. The survey consisted of 4 demographic items, eight questions ranking provider opinions on a 5-point Likert scale and two free-response questions regarding barriers and suggestions for improvement.

Results: The survey completion rate was 12.8%, including 36 internal medicine providers in 9 divisions. Most respondents (78%) strongly agreed that transitioning young adults with chronic childhood illnesses is important. Opinions were mixed on whether pediatricians should continue caring for chronic illnesses into adulthood -36% disagree or strongly disagree, 22% agree or strongly agree and 42% neutral. Most adult providers (72%) feel comfortable taking care of patients with childhood-onset chronic illnesses, but 50% felt this was challenging. Only 6 providers (17%) felt their division had an effective transition plan and only 4 (11%) reported adequate support staff. Nearly all providers surveyed (35/36) are comfortable including family members in the medical visit. The most commonly reported barriers to transition were poor communication between providers and inadequate preparation of patients (12 and 10, respectively). Seventeen responses noted patient-related barriers (e.g. poor preparation, poor adherence, complexity/ social issues and reluctance to transition). Ten cited adult provider-related barriers (e.g. insufficient availability of providers and support staff, lack of training and time).

Conclusions: Overall, providers for adult patients at this academic medical center consider transitioning young adults with chronic childhood illnesses important. However, very few have transition programs in place due to a variety of barriers, reflective of the national trends. This survey better describes the perceptions of adult providers on this important topic and illustrates key target areas for improvement of transitional care.

To cite this abstract:

Cafarchio, M; Hurrell, R; Millstein, L; Tepper, V . ASSESSING PERCEPTIONS AND EXPERIENCES OF ADULT-CARE PROVIDERS WITH TRANSITION FROM PEDIATRIC TO ADULT MEDICAL CARE. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 243. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/assessing-perceptions-and-experiences-of-adult-care-providers-with-transition-from-pediatric-to-adult-medical-care/. Accessed September 20, 2019.

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