Original ArticlesOutcome Evidence for Structured Pediatric to Adult Health Care Transition Interventions: A Systematic Review
Section snippets
Methods
Following the PRISMA checklist,22 we conducted a search strategy of articles published between January 1995 and April 2016 using the CINAHL, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases. Only English-language articles were included, and a combination of medical subject headings and keywords were used, as described in the Figure (available at www.jpeds.com).
Included studies described a transition intervention for youths transferring from pediatric to adult outpatient health care.
Results
This systematic review examined the evidence from 43 articles out of 3844 articles initially identified (Figure). Table II provides a summary of each study's characteristics. All but 5 studies26, 27, 35, 41, 52 evaluated transition interventions for youths with a single condition, most often type 1 diabetes, followed by kidney or liver transplants and juvenile idiopathic arthritis. Among the handful of multiple-condition studies, only 1 study31 included youths with neurodevelopmental
Discussion
This systematic review found that almost two-thirds of transition evaluation studies (28 of 43) had statistically significant positive outcomes. Twenty studies found improvements in population health, 8 studies reported benefits in terms of consumer experience or reduction in transition barriers, and 9 studies cited positive service utilization impacts. Only 3 studies examined costs, but none found significant savings.
In an analysis of studies that received moderate to strong quality ratings
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Cited by (0)
Supported by the Maternal and Child Health Bureau (U39MC25729 HRSA/MCHB) to The National Alliance to Advance Adolescent Health. M.M. and P.W. led the development of the Six Core Elements of Health Care Transition (2.0) in 2014. The other authors declare no conflicts of interest.