From 2016 to 2017, only 15% of adolescents received guidance from their health care provider on the transition from adolescent to adult health care; specifically, 10% of those aged 12 to 14 years received guidance, according to a study published in Morbidity and Mortality Weekly Report.
Researchers from the Centers of Disease Control and Prevention (CDC) analyzed pooled, parent-reported data from the National Survey of Children’s Health (NSCH) comparing adolescents (those aged 12-17 years) both with and without diagnosed mental, behavioral, and developmental disorders (MBDDs) on specific indicators of recommended health care transition planning by primary care providers (PCPs). MBDDs were identified based on parents’ affirmative response to the question, “Has a doctor or other health care provider indicated that your child has (specified disorder)?” Adolescents with no reported MBDDs comprised the control group.
Parents reported the severity of their child’s MBDD: mild, moderate, or severe. A 3-element measure for health care transition planning was used:
- Time alone with the PCP at last visit
- PCP worked with the adolescent to gain heath management skills or understand the changes in health care that occur at age 18
- PCP discussed the shift to an adult PCP.
The analysis included 29,286 adolescents who met MBDD and transition question requirements. A total of 14.6% of adolescents met the transition planning measure, and 24.2% had 1 or more MBDDs. Older adolescents (those aged 15-17 years) were more likely than their younger counterparts to meet the transition measure regardless of MBDD status. Adolescents with MBDDs were more likely to have time alone with their PCP and work with their PCP to gain health management skills than were adolescents without MBDDs; however, they were less likely to have discussed the shift to an adult provider with their PCP.
Those with emotional disorders, specifically depression, comprised the highest percentage of adolescents meeting the transition planning measure (26.8%). The lowest percentage of adolescents was those with developmental disorders (12.6%), specifically autism spectrum disorder (8.9%). Adolescents with MBDDs who received treatment were more likely to meet the transition measure than were those with MBDDs who did not receive treatment.
“All adolescents, especially those with MBDDs, could benefit from receiving earlier transition planning as recommended,” concluded the authors. “Improving access to comprehensive and coordinated programs and services, as well as increasing provider training concerning adolescents’ unique mental and physical health care needs, could help increase the number of adolescents benefitting from successful health care transitions.”
Leeb RT, Danielson ML, Bitsko RH, et al. Support for transition from adolescent to adult health care among adolescents with and without mental, behavioral, and developmental disorders – United States, 2016-2017. MMWR Morb Mortal Wkly Rep. 2020;69(34): 1156-1160.