Transition care continuity promotes long-term retention in adult care among young adults with sickle cell disease.
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BACKGROUND/OBJECTIVES: Care continuity prevents increased health care utilization and mortality during transition from pediatric to adult care. Our program employs a co-located care delivery model, in which pediatric provider involvement continues during young adulthood. We tested the hypothesis that individuals who participated in the co-located model have greater retention in adult care compared to those who only received pediatric transition services. METHODS: This study consisted of 311 youth with SCD (51.4% male; 63.0% HbSS/HbS0 -thalassemia) who transferred to adult care from 2007 to 2017. Retention was defined as continuation with an adult provider for 12 or 24months post-pediatric care. Logistic regression estimated the association between co-location status and retention at 12 and 24months. Logistic regression and t-tests were used to evaluate potential predictors of retention in adult care. RESULTS: Individuals who participated in the co-location model were 1.9 times more likely to remain in adult care 12 (95% CI: 1.01, 3.47) and 24 (95% CI: 1.01, 3.70) months post-pediatric care compared to those who did not participate. Individuals with HbSS/HbS0 -thalassemia were 1.9 times more likely to be retained at 12months compared to those with HbSC/HbS+ -thalassemia/HbS/HPFH (95% CI: 1.12, 3.09). For every clinic encounter in the last 2years of pediatric care, the odds of being retained at least 24months after initiating adult care increased 1.1 times (95% CI: 1.02, 1.13). CONCLUSIONS: Continuity of providers from pediatric to adult care may increase long-term retention in adult care. Longitudinal monitoring of adult outcomes is critical to identifying the efficacy of transition services.
Howell, K. E., Saulsberry-Abate, A. C., Mathias, J. G., Porter, J. S., Hodges, J. R., Ataga, K. I., ... Hankins, J. S.
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Howell, Kristen E||Saulsberry-Abate, Anjelica C||Mathias, Joacy G||Porter, Jerlym S||Hodges, Jason R||Ataga, Kenneth I||Anderson, Sheila||Nolan, Vikki||Hankins, Jane S
