Abstract
Objective: Seamless transition of endocrine patients from the paediatric to adult setting is still
suboptimal, especially in patients with complex disorders, i.e., small for gestational age, Turner
or Prader–Willi syndromes; Childhood Cancer Survivors, and those with childhood-onset growth
hormone deficiency.
Methods: An expert panel meeting comprised of European paediatric and adult
endocrinologists was convened to explore the current gaps in managing the healthcare of
patients with endocrine diseases during transition from paediatric to adult care settings.
Results: While a consensus was reached that a team approach is best, discussions revealed
that a ‘one size fits all’ model for transition is largely unsuccessful in these patients. They
need more tailored care during adolescence to prevent complications like failure to achieve
target adult height, reduced bone mineral density, morbid obesity, metabolic perturbations
(obesity and body composition), inappropriate/inadequate puberty, compromised fertility,
diminished quality of life and failure to adapt to the demands of adult life. Sometimes it is difficult for young people to detach emotionally from their paediatric endocrinologist and/
or the abrupt change from an environment of parental responsibility to one of autonomy.
Discussions about impending transition and healthcare autonomy should begin in early
adolescence and continue throughout young adulthood to ensure seamless continuum of
care and optimal treatment outcomes.
Conclusions: Even amongst a group of healthcare professionals with a great interest in
improving transition services for patients with endocrine diseases, there is still much work to be
done to improve the quality of healthcare for transition patients.
suboptimal, especially in patients with complex disorders, i.e., small for gestational age, Turner
or Prader–Willi syndromes; Childhood Cancer Survivors, and those with childhood-onset growth
hormone deficiency.
Methods: An expert panel meeting comprised of European paediatric and adult
endocrinologists was convened to explore the current gaps in managing the healthcare of
patients with endocrine diseases during transition from paediatric to adult care settings.
Results: While a consensus was reached that a team approach is best, discussions revealed
that a ‘one size fits all’ model for transition is largely unsuccessful in these patients. They
need more tailored care during adolescence to prevent complications like failure to achieve
target adult height, reduced bone mineral density, morbid obesity, metabolic perturbations
(obesity and body composition), inappropriate/inadequate puberty, compromised fertility,
diminished quality of life and failure to adapt to the demands of adult life. Sometimes it is difficult for young people to detach emotionally from their paediatric endocrinologist and/
or the abrupt change from an environment of parental responsibility to one of autonomy.
Discussions about impending transition and healthcare autonomy should begin in early
adolescence and continue throughout young adulthood to ensure seamless continuum of
care and optimal treatment outcomes.
Conclusions: Even amongst a group of healthcare professionals with a great interest in
improving transition services for patients with endocrine diseases, there is still much work to be
done to improve the quality of healthcare for transition patients.
| Original language | English |
|---|---|
| Pages (from-to) | R44-R54 |
| Journal | Endocrine Connections |
| Volume | 5 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Nov 2016 |
Bibliographical note
FundingPfizer Ltd. initiated and sponsored the ‘Bridging the Gap: Metabolic and
Endocrine Care of Patients during Transition’ meeting. SPC and Faculty
members received honoraria from Pfizer Ltd. for their participation.
Medical writing support for preparation of the manuscript was provided
by Pfizer Ltd. Prof. Allan Colver (Newcastle University, UK) presented
on the Specific Needs of the Adolescent with Chronic Disease during
Transition but did not contribute to the manuscript preparation. Prof
Colver had no conflict of interest.
Research programs
- EMC MM-01-39-01
- EMC MM-01-39-04
- EMC MM-01-54-01
