Evaluating outpatient transition clinics: a mixed-methods study protocol

Sattoe, Jane N. T.; Peeters, Mariëlle A C; Hilberink, Sander R.; Ista, Erwin; Staa, AnneLoes van

doi:10.1136/bmjopen-2016-011926

Cited by 23 publications

(19 citation statements)

References 90 publications

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“…Experienced barriers and facilitators for the functioning of the TC and perceived benefits were also studied. The study protocol has been published elsewhere …”

Section: Methodssupporting

confidence: 57%

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Controlled evaluation of a transition clinic for Dutch young people with cystic fibrosis

Peeters

Sattoe

Staa

et al. 2019

Pediatric Pulmonology

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Background Transition clinics (TCs) are advocated as best practice to support young people with cystic fibrosis (CF) during transition to adulthood and adult care. We aimed to research the functioning of a TC for young people with CF compared with direct hand‐over care and to evaluate whether those treated at the TC have better transfer experiences and outcomes compared with the control group. Methods Mixed‐methods retrospective controlled design, including interviews with professionals, observations of clinics, chart reviews (at four measurement moments), and patient surveys. Qualitative data analysis focused on organization and daily routines, and barriers and facilitators experienced. Young people's transfer experiences, self‐management, health care use, and clinical outcomes were assessed quantitatively. Results The most notable feature distinguishing the TC and direct hand‐over care comprised joint consultations between pediatric and adult care professionals in the former. A transition coordinator was considered essential for the success of the TC. The main barriers were lack of time, planning, and reimbursement issues. Young people treated at the TC tended to have better transfer experiences and were more satisfied. They reported significantly more trust in their adult care professionals. Their self‐management‐related outcomes were less favorable. Conclusions The TC had several perceived benefits and showed positive trends in transfer experiences and satisfaction, but no differences in health‐related outcomes. Structured preparation of young people, joint consultations with pediatric and adult care professionals, and better coordination were perceived as facilitating elements. Further improvement demands solutions for organizational and financial barriers, and better embedding of self‐management interventions in CF care.

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“…Experienced barriers and facilitators for the functioning of the TC and perceived benefits were also studied. The study protocol has been published elsewhere …”

Section: Methodssupporting

confidence: 57%

“…A set of background, process, and outcome variables was selected that previously had been found essential for a successful transition . Table provides an overview of our operationalization and data collection method per variable.…”

Section: Methodsmentioning

confidence: 99%

Controlled evaluation of a transition clinic for Dutch young people with cystic fibrosis

Peeters

Sattoe

Staa

et al. 2019

Pediatric Pulmonology

View full text Add to dashboard Cite

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“…We used a complementary approach and a concurrent triangulation strategy, collecting all data concurrently and comparing quantitative and qualitative data to assess concordance between them . The use of a mixed‐methods design is particularly indicated in the evaluation of complex interventions such as transition clinics, because it provides a richer and more complete understanding of these interventions . We collected data concurrently because it was more manageable as we had limited time for data collection, and the complementary approach was used to minimize the limitations of each approach…”

Section: Methodsmentioning

confidence: 99%

Mixed‐methods evaluation of a transition and young adult clinic for kidney transplant recipients

Michaud

Achille

Chainey

et al. 2019

Pediatric Transplantation

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The aims of the present study were to describe the experiences of kidney transplant patients attending a young adult clinic or a regular adult clinic, to explore similarities and differences between the groups, and to conduct an evaluation of the clinical and psychosocial outcomes of the young adult clinic, by comparing these outcomes to those of the regular adult clinic. A mixed‐methods design combining qualitative and quantitative data was used. Empirically validated questionnaires measuring self‐determination theory variables, quality of life, and adherence were distributed to all consenting patients attending the YAC (n = 17) and RAC (n = 16). Semi‐structured interviews were conducted with a subsample of the first (n = 10) and second group (n = 8), and analyzed using thematic analysis. Clinical outcomes were retrieved from medical records. Descriptive, correlational, and comparative analyses were performed. We found clinically significant differences on tacrolimus blood levels variability, self‐reported adherence, and physical quality of life. Small and medium effect sizes were detected. No statistical differences were found. Statistically significant correlations were found between self‐determination theory variables and both physical quality of life and different measures of adherence. Four themes characterized patients’ experiences: resilience; relational needs and the therapeutic alliance; quest for balance; and quest for normalcy. The young adult clinic seems to meet its initial objectives and to make a difference particularly in the early period post‐transition, but over time what matters most for patients is therapeutic alliance. Mental health issues need to be better addressed, and special attention should be paid to youths transplanted in an adult setting.

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“…We performed a retrospective, controlled evaluation of process, clinical and patient-reported outcomesbased on the original study design of Sattoe and colleagues [26]. Using a mixed methods approach, this evaluation focuses on the expected added value of transitional care investments containing different elements.…”

Section: Study Aim and Designmentioning

confidence: 99%

“…This was con rmed during the intake interviews in the participating teams. We inventoried the transitional care arrangements in each diabetes team at the start of the program using various methods, following the original study design [26]. Input came from the intake interviews at the start of the program, semi-structured interviews with professionals from both pediatric and adult care (n = 41), and observations of health professionals' consultations with young adults in both settings (n = 57).…”

Section: Data Collectionmentioning

confidence: 99%

The added value of transition programs in Dutch diabetes care: A controlled evaluation study

Peeters

Sattoe

Bronner

et al. 2020

Preprint

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Background The desirability of evaluating transition programs is widely acknowledged. This study aimed to explore the added value of transitional care investments for young adults with type 1 diabetes mellitus. Methods On the basis of qualitative data, two groups of diabetes teams were created through cluster analysis: paying more (HI-ATT) versus less attention (LO-ATT) to transitional care. Retrospective controlled evaluation included chart reviews on healthcare use and clinical outcomes; and a survey on young adults’ experiences, satisfaction with care, and self-management skills. Results Data from 320 patients in fifteen diabetes teams were collected; 142 young adults (38.4%) completed a questionnaire. Self-reported outcomes showed that young adults treated by a HI-ATT team felt better prepared for transfer (p <.05). Self-management outcomes did not differ between groups. HI-ATT teams had more scheduled consultations in the year after transfer (p <.05); only 10.6% of all participants had reached targeted HbA1c scores. Conclusions The attention being paid to transition in Dutch diabetes care does not lead to notable improvements in experiences and outcomes, except for preparation for transfer. The period after transfer, however, is just as important. Attention is required for parent involvement. Considering actual implementation and adaptation of interventions is recommended for future evaluation studies.

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Evaluating outpatient transition clinics: a mixed-methods study protocol

Cited by 23 publications

References 90 publications

Controlled evaluation of a transition clinic for Dutch young people with cystic fibrosis

Controlled evaluation of a transition clinic for Dutch young people with cystic fibrosis

Mixed‐methods evaluation of a transition and young adult clinic for kidney transplant recipients

The added value of transition programs in Dutch diabetes care: A controlled evaluation study

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