Are transition preparation consultations for adolescents with chronic conditions valuable? A mixed-methods study

Our objective was to assess the value of transition preparation consultations (TPC) offered by the AD 'venir unit (R. Debre hospital, Paris) as a new service of transitional care, from the perspective of adolescents with chronic conditions (CCs) and their referring healthcare providers (RHCPs). TPCs included a face-to-face interview with pediatricians trained in adolescent medicine, exploring the adolescent's past (CC history), present (daily life, Treatment Burden Questionnaire, family/peer relationships, school, hobbies, sexuality, drugs), and future (global life project, transition, Good2Go questionnaire). The mixed-methods design included the following: a qualitative analysis within a multidisciplinary group (clinicians/sociologists/psychologist/public health researchers) of audio-recordings of TPCs (n= 27/girls =56%/median age =17.7 years) and phone interviews with adolescents 2 years post-TPC (n=26); and a quantitative analysis of the Treatment Burden and Good2Go questionnaires and the benefits perceived by RHCPs (questionnaire 6 months post-TPC). TPCs were a form of training for adult care, adolescents meeting a practitioner alone often for the first time. Naming their CC was difficult. All complained of limitations experienced in social life (diet, fatigue, laboratory/medical appointments), but not the treatment itself; most adolescents willingly talked about sexuality. Adolescents' feelings about transition were various, with poor representations of adult healthcare. Transfer was frequently unplanned. After TPCs, RHCPs modified their practices. Transition in the 2 years post-TPC was usually successful. Conclusion: The TPC is a valuable, feasible intervention to highlight facilitators and barriers to a successful transition, initiate adolescents' reflections about their future, and customize their transition preparation within a holistic approach. This paper details the key elements of the TPC.

Automated summary

This study assessed the value of transition preparation consultations (TPC) for adolescents with chronic conditions and healthcare providers. TPCs included face-to-face interviews and questionnaires, and the results showed that TPCs were valuable in helping adolescents reflect on their future and customize their transition preparation.