Pediatric-to-adult healthcare transitions: Current challenges and recommended practices

Am J Health Syst Pharm. 2019 Sep 16;76(19):1544-1554. doi: 10.1093/ajhp/zxz165.

Abstract

Purpose: An overview of the pediatric-to-adult healthcare transition (HCT) process, including stakeholders, challenges, and fundamental components that present opportunities for pharmacists and pharmacy technicians, is provided.

Summary: Pediatric-to-adult HCT programs should be longitudinal in nature, be patient focused, and be coproduced by patients, caregivers, and care team members. Educational components of HCT programs should include knowledge and skills in disease state management and self-care; safe and effective use of medications, as well as other treatment modalities; and healthcare system navigation, including insurance issues. Interprofessional involvement in HCT is encouraged; however, roles for each discipline involved are not clearly delineated in current guidelines or literature. Possible influencing elements in achieving successful pediatric-to-adult HCT outcomes include those that are related to patient and/or caregiver factors, clinician awareness, availability of resources, and ability to achieve financial sustainability.

Conclusion: The use of structured pediatric-to-adult HCT programs is currently recommended to optimize patient and health-system outcomes. Given the importance of medication-related knowledge and healthcare system navigation skills to successful care transitions, there are opportunities for pharmacists and pharmacy technicians to contribute to HCT programs.

Keywords: adolescent; children with special health care needs, CSHCN; healthcare transition; self-management; transition of care.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Humans
  • Interprofessional Relations
  • Medication Therapy Management / organization & administration*
  • Medication Therapy Management / standards
  • Pharmacists / organization & administration
  • Pharmacy Technicians / organization & administration
  • Practice Guidelines as Topic
  • Professional Role
  • Stakeholder Participation
  • Transition to Adult Care / organization & administration*
  • Transition to Adult Care / standards
  • Young Adult