Results: The survey completion rate was 12.8%, including 36 internal medicine providers in 9 divisions. Most respondents (78%) strongly agreed that transitioning young adults with chronic childhood illnesses is important. Opinions were mixed on whether pediatricians should continue caring for chronic illnesses into adulthood -36% disagree or strongly disagree, 22% agree or strongly agree and 42% neutral. Most adult providers (72%) feel comfortable taking care of patients with childhood-onset chronic illnesses, but 50% felt this was challenging. Only 6 providers (17%) felt their division had an effective transition plan and only 4 (11%) reported adequate support staff. Nearly all providers surveyed (35/36) are comfortable including family members in the medical visit. The most commonly reported barriers to transition were poor communication between providers and inadequate preparation of patients (12 and 10, respectively). Seventeen responses noted patient-related barriers (e.g. poor preparation, poor adherence, complexity/ social issues and reluctance to transition). Ten cited adult provider-related barriers (e.g. insufficient availability of providers and support staff, lack of training and time).
Conclusions: Overall, providers for adult patients at this academic medical center consider transitioning young adults with chronic childhood illnesses important. However, very few have transition programs in place due to a variety of barriers, reflective of the national trends. This survey better describes the perceptions of adult providers on this important topic and illustrates key target areas for improvement of transitional care.