READY OR NOT, HERE I COME! COMPARING TRANSITION SKILLS AND KNOWLEDGE OF TEENS WITH CHRONIC CONDITIONS

BACKGROUND: Many adolescents now reach adulthood with a chronic condition (CC) and will transition from paediatric to adult healthcare. While the importance of being prepared for this transition is obvious, guidance provided by healthcare teams is rarely personalized, with unclear priorities.

OBJECTIVES: The purpose of this study is to determine transition skills and knowledge acquisition perceived by adolescents with CC, and compare them based on their CC.

DESIGN/METHOD: From March 2013 to October 2015, adolescents (14-18 yo) presenting one of 5 pre-selected CC (T1D, IBD, Epilepsy, CF and JIA) were invited to complete an anonymous self-administered questionnaire during a follow-up visit at one of 4 Paediatric hospitals (study accepted by their respective ERB). A convenient sample of 223 adolescents was recruited. In addition to demographic characteristics, the questionnaire, adapted from the Good to Go questionnaire (SickKids Hospital), includes items on 12 required skills (reported on a Likert-scale ranging from 1 to 5; achieved: I do, and I always do) and 9 knowledge (reported on a Likert-scale ranging from 1 to 5; achieved: I know well, and I totally know) depicting key capacities for a smooth transition. Descriptive statistics were used, focusing on readiness defined as 8 /12 skills, and 6/9 knowledge. Chi-square and multivariate logistic regressions were used to compare transition skills and knowledge based on participants’ CC.

RESULTS: Mean age of participants was of 16.0 yo and 49.8% were girls. The 2 most represented CC were T1D (35%) and IBD (25%). The most-achieved items were knowing about their right to be informed (88.6%) and knowing about the name of their medications/treatments (86.0%). The top challenges were organizing their health care (23.5%), and talking about alcohol, tobacco and drug’s effects during a consultation (26.0%). When items were added up, 22.4% of adolescents perceived themselves as skills ready, while 57.4% knowledge ready towards transition. With several significant differences seen on specific capacities, only knowledge readiness differed between participants based on their CC (p=0.41) with T1D displaying the highest proportion (67.9%). On multivariate analysis, CC was not a significant factor for skills and knowledge readiness taking into account age and gender.

CONCLUSION: While vastly diverging on their mastering of key capacities, several adolescents perceived themselves as having sufficiently acquired knowledge rather than skills towards transition. Yet, the majority of adolescents could be described as underprepared, regardless of their CC. Using readiness questionnaire may help focus on and follow individual challenges.