Transitional Care in Endocrinology

Abstract

Transition from pediatric to adult-oriented care is often characterized by a lack of coordination and discontinuity in care resulting in poor health outcomes as well as diminished psychosocial well-being and impaired quality of life. Most young adults seen in endocrine consultation have chronic, often rare diseases that require coordinated transitional care (TC). While endocrine TC is widely acknowledged as important, relatively few models have been formally evaluated. This review provides an overview of the relevance of TC in endocrinology, summarizes the needs of young adults and families for TC, and highlights the multidimensional considerations for TC. Particular attention is given to the role of nursing in endocrine TC. We report findings of a structured literature review identifying the current state of disease-specific TC in endocrinology for growth hormone deficiency, congenital hypothyroidism, congenital hypogonadotropic hypogonadism, Klinefelter syndrome, Turner syndrome, congenital adrenal hyperplasia, disorders/differences of sex development, and late effects. We show the results of a structured endocrine TC program with a dedicated transition nurse implemented at the University Hospital of Lausanne (Switzerland). Implications for practice, teaching, and research are discussed, and key advice and resources are highlighted.