Abstract: FR-PO728
Obstacles in Establishing Transition Clinics in Pediatric and Adult Medical Centers
Session Information
- Pediatric Nephrology - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Vissing, Andrew, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
- Verghese, Priya S., Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
- Dixon, Angelina Magreni, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Ghossein, Cybele, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
Background
In 2011, the International Society of Nephrology published a consensus statement regarding the importance of a transition process from pediatric to adult care for young adults with kidney disease, ideally facilitated through transition clinics. Despite this recommendation, institutions continue to struggle with the transfer and transition of care for this group. Here we report on potential barriers to implementing this recommendation.
Methods
Four different surveys were created to assess transition practices in adult and pediatric general nephrology and transplant nephrology care. Surveys were distributed via email to the leadership of academic general and transplant nephrology programs. Respondents without a transition clinic were asked to identify the primary obstacles to establishing such a clinic. The identified obstacles were classified into one or more of the following categories: logistics, resources, provider-related, patient-related, or absence of need/obstacles. Fisher’s exact test was used (P < 0.05) to compare frequencies of obstacles between the adult and pediatric programs.
Results
There were a total of 119 comments. The most frequently mentioned barrier for adult programs was resources (53%) and for pediatric programs was provider-related (52.8%). Patient-related obstacles were statistically less cited in adult programs compared to pediatric programs (1.5% vs 15.1%, P = 0.01). Adult programs were more likely to mention no perceived need/obstacles compared to pediatric programs (16.7% vs 3.8%, P = 0.04). There was no statistical difference in how frequently other obstacles were mentioned between the two groups.
Conclusion
Despite guidelines recommending pediatric to adult transition programs for young adults, transition clinics remain uncommon in nephrology transitions of care. Resource availability as well as provider-related obstacles, are the main perceived barriers by both pediatric and adult programs. Future work will involve understanding and overcoming these barriers.
Obstacles for Establishing a Transition Clinic
| Obstacles | Adult Programs (n=66) | Pediatric Programs (n=53) | p-value |
| Logistics | 17 (25.8%) | 19 (35.8%) | 0.32 |
| Resources | 35 (53.0%) | 24 (45.3%) | 0.46 |
| Provider-related | 29 (43.9%) | 28 (52.8%) | 0.36 |
| Patient-related | 1 (1.5%) | 8 (15.1%) | 0.01 |
| No Perceived Need or Obstacles | 11 (16.7%) | 2 (3.8%) | 0.04 |