Practices, attitudes and barriers faced by internists and pediatricians in transitioning young adult patients to adult medicine

Purpose: To assess perspectives of clinicians at an academic medical center regarding current practices, barriers and possible interventions in transitioning young adult patients to adult care. Methods: Electronic survey results from licensed independent providers in the Departments of Internal Medicine (n = 87) and Pediatrics (n = 49) were analyzed. Results: The majority of providers at our institution are unaware of and do not follow national transition guidelines. Seventy-seven percent of pediatricians provide the majority of preparation and support in transition care of young adults with complex medical conditions without involvement of other interprofessional team members. Ninety-six percent of internists report not receiving formal training related to transition care and only 44% are comfortable caring for young adults with medical complexity. Eighty-eight percent of pediatricians and internists support a standard transition process, yet significant gaps in this process exist. Conclusion: Despite the existence of national society-supported recommendations for transitions of care processes, lack of awareness among providers regarding national transition guidelines has led to uncertainty when it comes to managing the transition of young adult patients. There is lack of communication between pediatricians and internists, and internists are not as confident in caring for young adult patients. The scope of work of the interprofessional team is not utilized adequately. Providers agree on the importance of developing a standardized pediatric to adult transition process. These results help inform possible future interventions to improve care for this population.