Evaluation of a systems navigator model for transition from pediatric to adult care for young adults with type 1 diabetes
Norma Van Walleghem, Catherine A Macdonald, Heather J Dean, Norma Van Walleghem, Catherine A Macdonald, Heather J Dean
Abstract
Objectives: To determine whether a systems navigator service, The Maestro Project, could increase medical surveillance for young adults with type 1 diabetes who transfer from pediatric to adult care.
Research design and methods: There were two cohorts of participants: 1) a younger group (aged 18 years, n = 82) who had the assistance of the navigator as they graduated from pediatric care and 2) an older group (aged 19-25 years) who were transferred to adult care without this initial support but later enrolled in the program.
Results: Of the older group (who did not have initial access to the navigator), 40% dropped out of adult medical care, compared with a dropout rate of 11% for the younger group, who had access to the navigator at the time of transfer from pediatric care.
Conclusions: The systems navigator helped improve medical surveillance for both groups, although there was no evidence of improved short-term medical outcomes.
References
- Bryden KS, Dunger DB, Mayou RA, Peveler RC, Neil HAW: Poor prognosis of young adults with type 1 diabetes. Diabetes Care 26:1052–1057, 2003
- Frank M: Factors associated with non-compliance with a medical follow-up regimen after discharge from a pediatric clinic. Can J Diabetes 20:13–20, 1996
- Kipps S, Bahu T, Ong K, Ackland FM, Brown RS, Fox CT, Griffin NK, Knight AH, Mann NP, Neil AW, Simpson H, Edge JA, Dunger DB: Current methods of transfer of young people with type 1 to adult services. Diabet Med 19:649–654, 2002
- Pacaud D, McConnell B, Huot C, Aebi C, Yale JF: Transition from pediatric care to adult care for insulin-dependent diabetes patients. Can J Diabetes 20:14–20, 1996
- Pacaud D, Yale JF, Stephure D, Trussell R, Davies D: Problems in transition from pediatric care to adult care for individuals with diabetes. Can J Diabetes 29:13–18, 2005
- Reiss J, Gibson R: Health care transition: destinations unknown. Pediatrics 110:1307–1314, 2002
- Saunders SA, Wallymahmed M, MacFarlane IA: Glycemic control in a type 1 diabetes clinic for younger adults. QJM 97:575–580, 2004
- Whittaker C. Transfer of young adults with type 1 diabetes from pediatric to adult diabetes care. Diabetes Quarterly Spring:10–14, 2004
- Van Walleghem N, MacDonald C, Dean HJ: Building connections for young adults with type 1 diabetes in Manitoba: feasibility and acceptability of a transition initiative. Chronic Dis Can 27, 2006
Source: PubMed