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Abstract
Introduction Transition is defined as the purposeful and planned movement of adolescents and young adults with chronic physical and medical conditions from child centred to adult orientated health care services.1 Evidence supports that poorly planned transition in asthma is associated with an increased risk of non-adherence and loss to follow-up during a highly vulnerable period. It is essential that the transition process is co-ordinated and matched to developmental abilities of individuals and care not simply transferred at the age of 16 as has historically been the case. In line with NICE guidance on transition planning, we aimed to set up a regional transition service for severe asthma engaging young adults and their carers in service design and delivery.
Methods A questionnaire aimed at exploring concerns and issues surrounding transition planning was developed and sent to asthmatics aged 14–16, on step 4 or 5 treatments under paediatric services across the region. Two focus discussion groups were held inviting families of those due to transition shortly and those who had recently transferred care.
Results 17 completed questionnaires were analysed: median age 15 years, 9 male, average number of admissions per year 3.3. 71% expressed worries about their care moving to adult services and 94% felt that it was important that they were prepared for the move. Effective information sharing and communication were considered key, along with the provision of a named transition co-ordinator, meeting the adult team early and a gradual process of transition over 2 years. 8 families participated in the focus groups and similar themes emerged. Those who had recently transferred care felt unsupported and vulnerable, expressing anxiety surrounding emergency admissions. Shared pre-planned care pathways, asthma passports and alerts linked to health records were considered important.
Conclusion Based on this feedback, we co-produced a patient-centred transition model with our young adults (figure 1) and at North Manchester have established a young adult severe asthma clinic. To date, 31 young adults are currently transitioning to one of 3 adult centres in the region and evaluation of services and patient experience are under review.
Reference
Blum RW. Journal Adolescent Health1993;14(7):570–6.
