Patient and family perspectives of a Pre-Transition Visit in a paediatric tertiary care diabetes clinic.

The need to better prepare youth with type 1 diabetes for the transition from paediatric to adult care is evident. As part of a regional quality improvement initiative, a novel Pre-Transition (Pre-T) Visit was developed and piloted at a paediatric tertiary care centre in January 2018 for patients aged 15-18 years to capture the status of their self-management skills, introduce transition tools and identify self-care goals and knowledge gaps to be addressed prior to transition. To evaluate patient and family satisfaction, visit relevance and patient engagement with a novel Pre-T Visit. From May 2019 to March 2020 a survey was offered to all youth who attended a Pre-T Visit and their parent(s)/caregiver(s). Patient and family satisfaction with, relevance of and engagement with the Pre-T Visit were evaluated using a 5-point Likert scale. Multivariable regression was used to assess patient factors associated with patient level satisfaction. Of the 63 youth who participated in a Pre-T Visit, 60 completed the survey. Mean age (SD) of participants was 16.7 (0.8) years; 47% were female. Mean (SD) haemoglobin A1C (A1C) was 8.2% (1.8). Patients reported high levels of satisfaction (95% quite or extremely satisfied) that were consistent across age, A1C, gender and disease duration. Visit relevance and engagement were also rated highly by youth. Parent participants (n=27) also reported high levels of satisfaction (89% quite or extremely satisfied) and relevance. Pre-T Visits were rated highly by patients and their parents. Their impact on glycaemic control and health outcomes following transition requires further study.

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Déclaration de conflit d'intérêts

Competing interests: The authors declare that the following financial interests/personal relationship which may be considered as potential competing interests: AA and EBG are coinvestigators for the Medtronic study entitled 'Multi-center, Randomized, Parallel, Adaptive, Controlled trial in Adult and Pediatric Patients with Type 1 Diabetes Using Hybrid Closed Loop System and Control (CSII, MDI, SAP) at Home'. Medtronic provided funds to cover the cost of supplies and research staff time for this study, but investigators did not receive payment. LS is receiving payment as research staff for the Medtronic study entitled 'Multi-center, Randomized, Parallel, Adaptive, Controlled trial in Adult and Pediatric Patients with Type 1 Diabetes Using Hybrid Closed Loop System and Control (CSII, MDI, SAP) at Home'. JS-D-M is receiving payment from Tandem and Medtronic for her role as an insulin pump educator.