Abstract: FR-PO492

Assessing Success in Transitioning of Young Adults from Pediatric to Adult Kidney Practice

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Ghossein, Cybele, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
  • Langman, Craig B., Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
  • Joslin, Benjamin, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
Background

Transfer from a pediatric to an adult medical setting is associated with many barriers. There are little data on patients’ assessment of the transition process itself. Three years ago at Lurie Children’s Hospital, we established a kidney transition program with the help of an adult nephrologist, physician assistant and social worker. After 18 months, we evaluated the patients’ perception of the program.

Methods

Patients who had transitioned from pediatric care and were seen at least once in the adult clinic were asked to take an established 5-point Likert scale survey. Survey questions addressed readiness to transition, the transition process itself, and the perception of adult care. Responses were categorized into Top 2 Box (“strongly agree” or “agree”) and Bottom 2 Box (“strongly disagree” or “disagree”).
Surveys were followed with semi-structured interviews. Three readers rated each response as either “negative,” “neutral,” or “positive.” Average, standard deviation and reader reliability were calculated. The readers also selected a word that best depicted each response and those most-common words were counted by question and overall.

Results

17 out of 42 patients completed the survey. Average age at transition (mean + SD) was 20 + 2 years; the majority of patients (82%) felt ready to transfer to adult care but only 59% felt they were consulted on the timing. 88% of patients felt having a transition appointment and meeting the adult care providers in the pediatric setting to be valuable. Although 94% of patients ultimately felt comfortable in the adult care environment, 18% experienced noticeable differences in treatment recommendations. 13 semi-structured interviews were conducted. Overall, the patients responded positively (3+0, 100% reader reliability) to the transition. But, when asked what could have improved the transition, the word the patients used most was, “earlier.”

Conclusion

Young adults transitioning to adult care often feel ready to transition earlier than their transfer of care date. They subjectively benefit from a transition program that outlines the process of transferring their care. Communication regarding differences in treatment between pediatric and adult nephrology care is warranted.

Funding

  • Private Foundation Support