The Experience of Transition from Childhood to Adulthood in Endocrinology

Objective: As transition to admission to adult polyclinics can be stressful both for children with chronic diseases and their families, our study aims to present the methods we used during this transition period. Material and Method: The patients who were transferred to adult endocrinology polyclinic with two different transition models between 2001-2017 were evaluated in the study. In the first model (Model 1), transition was conducted in a single meeting with pediatric and adult endocrinologists, whereas patients and/or their relatives had either participated or not (by the help of patient records). And in the second model (Model 2), patients were transferred to the adult endocrinology polyclinic , after being seen and evaluated at the “Transition Outpatient Clinic” for at least 4-6 months intervals by using the forms prepared by the Associations of Pediatric and Adult Endocrinology; and a mutual clinic follow-up was carried out for a year, with 4-6 month-intervals. In addition, the patient satisfaction scale prepared by the Psychiatric Clinic was used to evaluate the opinions of patients and their relatives, regarding the transition. Results: Among 373 patients(312 females, 161 males,18-31 years) transferred with Model 1; 26% had thyroid diseases, 25% had diabetes (DM), 9% had congenital adrenal hyperplasia (CAH), 5% had multiple pituitary hormone deficiency (MPHD), 3% had growth hormone deficiency (GHD), 2% had Turner syndrome (TS), 2% had disorders of sex development (DSD), 3% had obesity-hyperinsulinemia, 4% had adolescent health problems, 7% had calcium/bone metabolism disorders, 6% had idiopathic short stature and 3% was in the “others” group. 8% of these patients had at least 1 outpatient application to adult endocrinology. Among 27 patients transferred with Model 2 (19 female, 6 male, 19-22 years); 48% of the diagnoses had DM, 19% had MPHD, 11% had GHD, 11% had thyroid diseases, 22% had CAH, 4% had DSD, and 4% had hypogonadism; and all these patients have follow-ups going on. Conclusion: A transition conducted by the mutual evaluation and follow-up of pediatric and adult endocrinologists for a while is thought to be effective on reducing the patients’ anxiety and the negative effects observed during the transition periods.