Transition of Care: Empowering Young Patients to Manage Their Own Health

About 18 million adolescents have a chronic medical condition, with more than 90% projected to survive into adulthood. Current barriers exist during adolescent to adult transition of care for patients with autoimmune diseases.

According to a presentation by Anita Afzali, MD, MPH, from The Ohio State University Wexner Medical Center, during the transition to adult care, patients can experience increased disease activity, develop flares as a young adult, experience lower self-esteem, may be at increased risk for psychiatric disorders, have joint pain, and have lower treatment adherence.

A majority of young adults do not complete a successful transition to an adult provider due to patient and provider barriers. Some barriers include:

• patient readiness and maturity;
• choice of health insurance;
• cognitive ability;
• lack of funding at a provider’s office;
• lack of trust or communication between patient and provider; and
• the variation in healthcare systems.

In preparing the transition, it will be up to the provider to keep the patient engaged in conversation and medical visits and make age-appropriate goals. A provider should not ignore the patient and only speak to the caregiver or parent and avoid disengagement of the patient.

“We want to empower our patients and ensure autonomy for our patients,” Afzali said during her presentation.

The goals of transition are to prepare patients, make the transfer of care, and integrate them into adult-centered care, to improve the ability of the young adult patient to manage their own health.

Reference:

Afzali A. Transition of the adolescent from pediatric to adult care providers. Presented at: Interdisciplinary Autoimmune Summit; April 5-7, 2019; Chicago, IL.