A Novel Receivership Model for Transition of Young Adults With Diabetes: Experience From a Single-center Academic Transition Program.

Autor:	Iyengar JJ; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan. Electronic address: jmacd@med.umich.edu., Ang L; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Rodeman KB; Department of Maternal Fetal Medicine and Endocrinology, Promedica Physicians Group, Perrysburg, Ohio., Rao A; Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona., Lin YK; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Broome DT; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Fanous N; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Reinert RB; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Konigsberg A; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Weatherup E; Adult Diabetes Education Program, Michigan Medicine, Ann Arbor, Michigan., Hagar C; Adult Diabetes Education Program, Michigan Medicine, Ann Arbor, Michigan., Rogosch D; Adult Diabetes Education Program, Michigan Medicine, Ann Arbor, Michigan., Florek J; Division of Endocrinology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan., Carey B; Division of Endocrinology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan., Wyckoff J; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan., Lee J; Division of Endocrinology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan; Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan., Thomas IH; Division of Endocrinology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan., Soleimanpour SA; Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan; Medicine Service, Endocrinology and Metabolism Section, VA Ann Arbor Healthcare System, Ann Arbor, Michigan. Electronic address: ssol@med.umich.edu.
Jazyk:	angličtina
Zdroj:	Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2024 Feb; Vol. 30 (2), pp. 113-121. Date of Electronic Publication: 2023 Nov 27.
DOI:	10.1016/j.eprac.2023.11.008
Abstrakt:	Objective: The transition from pediatric to adult care for young adults with diabetes represents an important but often challenging time characterized by a shift from a family-centered care model of pediatrics to a patient-centered care model of adult medicine. We developed a structured transition program based on an adult receivership model at a large academic medical center to improve care coordination and patient satisfaction with the transition process. Methods: From 2016 to 2020, we implemented a series of quality improvement efforts for young adults aged 18 to 23 years with diabetes by incorporating best practices from the American Diabetes Association guidelines on care for emerging adults. We measured transition orientation attendance, patient satisfaction, hemoglobin A1c (HbA1c) pre- and post-transfer, and care gaps to determine the impact of the program. Results: In this study, 307 individuals with type 1 diabetes and 16 individuals with type 2 diabetes were taken care of by the adult endocrinology department at the University of Michigan between January 1, 2016 and October 31, 2020. We observed high attendance rates (86% among internal transfers) and favorable patient satisfaction scores for the transition orientation session. Despite the glycemic challenges posed during the transition, HbA1c modestly yet significantly improved 1-year after transfer (-0.4%, P < .01). Conclusion: We successfully established and maintained a young adult diabetes transition program using a quality improvement approach. Future work will focus on reducing care gaps at the time of transfer, assessing long-term retention rates, and enhancing care coordination for patients referred from outside the health network. Competing Interests: Disclosure S.A.S. has received grant funding from Ono Pharmaceutical Co, Ltd and is a consultant for Novo Nordisk. D.T.B. receives grant funding from Novo Nordisk, Rhythm Pharmaceuticals, Inc, and Fractyl Health Laboratories, Inc. J.M.L. is on the Medical Advisory Board for GoodRx and is a consultant for Tandem Diabetes Care. All other authors have no conflicts of interest to disclose. (Copyright © 2023 AACE. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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