Current methods of transfer of young people with Type 1 diabetes to adult services

作者：Sarah Kipps, Teresa Konopelska Bahu, Ken K. Ong, F.M. Ackland, Richard S. Brown, Catherine Fox, Nicole Griffin, A H Knight, Nicholas P. Mann, H. A. W. Neil, H.C.R. Simpson, Julie Edge, David B. Dunger · 发表于：Diabetic Medicine · 年份：2002 · DOI：10.1046/j.1464-5491.2002.00757.x · 被引用次数：330 · 研究领域：Adolescent and Pediatric Healthcare、Diabetes Management and Research、Primary Care and Health Outcomes

AIMS: To determine the efficacy and patient perception of various transfer procedures from paediatric to adult diabetes services. METHODS: Comparison between four districts in the Oxford Region employing different transfer methods, by retrospective study of case records and interviews of patients recently transferred from paediatric diabetes clinics. The main outcome measures were age at transfer, clinic attendance rates, HbA1c measurements and questionnaire responses. RESULTS: Two hundred and twenty-nine subjects (57% males) > 18 years old in 1998 and diagnosed with Type 1 diabetes < 16 years of age between 1985 and 1995, identified from the regional diabetes register. The notes audit was completed for 222 (97%) and 164 (72%) were interviewed by a single research nurse. Mean age at transfer was 17.9 years (range 13.3-22.4 years). Few young people were lost to follow-up at the point of transfer. There was a high rate of clinic attendance (at least 6 monthly) 2 years pretransfer (94%), but this declined to 57% 2 years post-transfer (P < 0.0005). There was large interdistrict variation in clinic attendance 2 years post-transfer (29% to 71%); higher rates were seen in districts where young people had the opportunity to meet the adult diabetes consultant prior to transfer. The importance of this opportunity was confirmed by questionnaire responses on interview. CONCLUSIONS: Adolescence is a vulnerable period for patients with diabetes. This regional survey demonstrated a marked d...