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Original research
Patient and family perspectives of a Pre-Transition Visit in a paediatric tertiary care diabetes clinic
  1. Alexa Marr1,2,
  2. Anne Tsampalieros3,
  3. Jennilea Courtney3,
  4. Jemila Seid Hamid3,4,
  5. Josee St-Denis-Murphy1,
  6. Liz Stevens1,3,
  7. Alexandra Ahmet1,2,3,
  8. Ellen B Goldbloom1,2,3
  1. 1Division of Endocrinology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
  2. 2Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
  3. 3Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
  4. 4Mathematics and Statistics, University of Ottawa, Ottawa, Ontario, Canada
  1. Correspondence to Dr Ellen B Goldbloom; egoldbloom{at}cheo.on.ca

Abstract

Introduction 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.

Purpose To evaluate patient and family satisfaction, visit relevance and patient engagement with a novel Pre-T Visit.

Methods 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.

Results 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.

Conclusions Pre-T Visits were rated highly by patients and their parents. Their impact on glycaemic control and health outcomes following transition requires further study.

  • transition to adult care
  • patient satisfaction
  • paediatrics
  • diabetes mellitus

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the manuscript or uploaded as supplementary information (questionnaires). Additional data are available upon request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjoq-2021-001563

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    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the manuscript or uploaded as supplementary information (questionnaires). Additional data are available upon request.

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    Footnotes

    • Contributors AM designed the study with EBG, contributed to patient recruitment, led the data acquisition, drafted the initial manuscript, interpreted the data, revised the manuscript and produced the final version of the manuscript with EBG. AT led the data analysis with JSH, helped interpret the results, revised the manuscript and approved the final version for publication. JC contributed to development of the study protocol, revised the manuscript and approved the final version for publication. JSH contributed to development of the study protocol and developed statistical analysis plan, led the data analysis with AT, helped interpret the results, revised the manuscript and approved the final version for publication. JS-D-M and LS contributed to development of the study protocol, led participant recruitment and contributed to data acquisition. They revised the manuscript and approved the final version for publication. AA provided input into the implementation of the Pre-Transition Visit, revised the manuscript and approved the final version for publication. EBG led the development and implementation of the Pre-Transition Visit with JS-D-M and LS with input from the CHEO diabetes team, designed the study with AM, interpreted the data, revised the manuscript critically for important intellectual content and produced the final version of the manuscript with AM. EBG is responsible for overall content as the guarantor.

    • Funding AM received a Resident Research Grant through the Children’s Hospital of Eastern Ontario (CHEO) Research Institute.

    • 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.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.