NCT03342495

Evaluating Innovations in Transition From Pediatric to Adult Care - The Transition Navigator Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 337 (actual)
• Sponsor: University of Calgary · Academic / Other
• Sex: All
• Age: 16 Years – 21 Years
• Healthy volunteers: Not accepted

Summary

The Transition Navigator Trial (TNT) is a pragmatic randomized controlled trial evaluating the effectiveness of usual care plus a patient navigator service versus usual care plus newsletters and other educational materials, to improve transition outcomes among adolescents aged 16-21 who have chronic health conditions requiring transfer to adult specialty care. The study will provide urgently needed data to guide health care providers and policy makers regarding the provision of coordinated transition care. These results have the potential to: 1. Change care delivery 2. Improve health outcomes 3. Improve the experiences of young adult transition to adult care

Detailed description

Transition is the purposeful, planned movement of adolescent and young adults with chronic health conditions from child-centered to adult-oriented health systems. Transition includes, but is not limited to transfer to adult care. Transfer of care, which occurs during a vulnerable developmental period around age 18 introduces gaps in continuity of care that can lead to detrimental health outcomes in young adults. Therefore, provision of coordinated and developmentally appropriate care during the transition period is necessary to maintain health and to sustain investments made in pediatric health care. Clinical practice guidelines for transition to adult care recommend the use of patient navigators to coordinate the entry of patients into a complex and unfamiliar adult health care system. Patient navigators provide individualized supports to facilitate medical follow-up and adherence. A limited number of studies have shown that access to a patient navigator during transition decreases drop-out from medical care and disease specific adverse events. No study to date has evaluated the benefits of a patient navigator to improve patient and or health system outcomes, when implemented across multiple chronic disease settings. Objectives/Methods 1. to evaluate the impact of a patient navigator intervention compared to treatment as usual for 16 to 21 year olds living with chronic health conditions who are transferring to adult care with respect to healthcare utilization and patient reported outcomes 2. to obtain perceptions of stakeholders regarding the role of patient navigators in reducing barriers to adult-oriented ambulatory care 3. to determine the net health care cost impact attributable to the navigator intervention A qualitative study sampling participants randomized into the intervention arm at the beginning and end of the trial will also be undertaken to understand the patient experience.

Conditions

• Diabetes
• Endocrine System Diseases
• Gastro-Intestinal Disorder
• Neuro-Degenerative Disease
• Epilepsy
• Autoimmune Diseases
• Renal Disease
• Cardiac Disease
• Metabolic Disease
• Genetic Diseases, Inborn
• Respiratory Disease
• Hematologic Diseases
• Autism Spectrum Disorder
• Fetal Alcohol Spectrum Disorders
• Traumatic Brain Injury
• Stroke

Interventions

Type	Name	Description
OTHER	Patient Navigator	Social worker/Patient Navigator will be assigned to follow youth in adult care for up to 24 months to assist youth adapt and attach to adult delivered healthcare
OTHER	Usual Care	Whatever processes are in place in a variety of clinics to support transfer from pediatric to adult care in the pediatric clinics

Timeline

• Start date: 2018-02-06
• Primary completion: 2021-08-31
• Completion: 2021-09-07
• First posted: 2017-11-17
• Last updated: 2023-06-12

Locations

3 sites across 1 country: Canada