Transition From Pediatric to Adult Care for Young Adults With Chronic Respiratory Disease

Advances in medicine and technology have led to improved survival rates of children with chronic respiratory disease such as cystic fibrosis, neuromuscular disease, and ventilator dependence. Survival into adulthood has created the need for adult specialists for conditions originating in childhood. Transition from pediatric to adult health care is a process that requires advanced planning and preparation and is not a one-time transfer event. Transition should be standard practice, but many children with special health care do not experience successful transition outcomes. Barriers to successful transition include lack of a standardized process, inadequate planning, and poor communication. Adverse outcomes have occurred in cases of abrupt or haphazard transfers. A successful transition process includes early introduction and ongoing discussion that engages the adolescent to plan and prepare for the eventual transfer of care. Care responsibilities should be gradually shifted from the parent to the adolescent in a manner appropriate for the adolescent's age and developmental status. Good communication and collaboration between pediatric and adult care teams is crucial to ensure a smooth transfer of care. Incorporating the 6 core elements of transition can be helpful in developing a successful transition program. This narrative review summarizes the literature for health care transition from pediatric to adult care including the rationale, barriers, factors associated with successful transition, and special considerations. The intent of this review is to increase clinician awareness of health care transitions and the components necessary for an effective transfer of young adults with chronic respiratory disease. Understanding the transition process is an important consideration for both pediatric and adult clinicians, including respiratory therapists.