Transition readiness in adolescents and emerging adults with diabetes: the role of patient-provider communication

Abstract

Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care.

Figure 1

Patient-provider interactions during the transition process. High-quality, developmentally appropriate communication with a health care provider plays a key role in preparation for transition to adult medical care. Support for decision making, independent responsibility, and transition readiness in pediatric care may contribute to improved health outcomes and increased engagement in adult medical care.