Endocrine Abstracts

Introduction: Various models of transition are used to help engage and improve the health of young adults. Our transition clinic model: a multi-disciplinary endocrine Adolescent Transition Clinic (ATC), was instituted at the Royal Hospital for Sick Children, Glasgow, in October 2008 serving young people in the West of Scotland. A good transition process should improve clinic attendance, health outcomes and quality of life into adulthood.

Aim: To review the ATC model in engaging young people following their transfer to adult endocrine services.

Methods: ATC lists were reviewed to identify patients who were no longer being reviewed in a paediatric setting. Confirmation of transfer was obtained by reviewing the last ATC letter. A combination of a Glasgow-wide electronic patient records and contact with medical secretaries was used to determine clinic attendance and DNA rates between final ATC and June 2011. Results are expressed as median (range).

Result: 14 young people (8 male), with median age at last ATC visit of 18.7 yrs (16.5, 23) were transferred to 6 adult endocrine services in the West of Scotland after 2 (1, 3) ATC attendances. Diagnoses included: Panhypopituitarism (9); Congenital Adrenal Hyperplasia (2); Klinefelter syndrome (1); Congenital Hypothyroidism (1) and Hypogonadotrophic Hypogonadism (1). Frequency of adult endocrine clinic attendance was 4 (1, 5) clinics/year. Interval between last ATC to adult clinic was 0.45 (0.09,1.14) yrs. All patients attended the first adult clinic appointment offered. The subsequent DNA rate was only 9% with no young person lost to follow-up. Of 14, 11 had complex care needs requiring input from more than one adult subspecialty team.

Conclusion: Our endocrine ATC model is successful in engaging young people in adult endocrine care, including those with complex care needs. A dedicated young-adult endocrine clinic, in the adult hospital, may help retain young people in an adult clinic setting long-term.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.