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

Abstract

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.