News & Research

    Oregon Health & Science University, Portland, Oregon

T1DM grows up: novel intervention for transitioning patients from pediatric to adult care

General Research Subject: Type 1 Diabetes

Focus: Pediatrics\Type 1, Psychosocial Behavioral Medicine

Type of Grant: Junior Faculty

Project Start Date: January 1, 2012

Project End Date: December 31, 2014

Diabetes Type: Type 1 diabetes

Research Description

Young people with diabetes transitioning from pediatric to adult care frequently do not obtain medical care until they have severe medical problems.  In addition, these young people struggle to care for their diabetes resulting in unnecessary hospitalizations and premature onset of diabetes-related complications.  There are no research-based models for successfully transitioning these patients to adult care.  Current approaches to transitioning youth with diabetes from pediatric to adult care have focused on changing behaviors of adolescents and their families.  No one has developed or tested the effectiveness of an intervention focusing on changing behaviors of medical providers caring for youth with diabetes.  Similar interventions with physicians caring for other populations have increased patient self-care and improved patient outcomes.  This study involves the development and implementation of an intervention for providers caring for young people with diabetes at a large medical center.  The medical providers will be randomized to participate in an 8-week educational session followed by a 15 month implementation phase or standard medical care.  The effectiveness of clinical care after the intervention will be compared to the effectiveness of clinical care before the intervention by analyzing frequency of providers' discussion and planning for transition and its impact on patient clinical outcomes, including clinic attendance and treatment adherence.  If successful, this model could be replicated at other institutions caring for adolescent patients with diabetes or other medical conditions.

Research Profile

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?

Young people with diabetes transitioning from pediatric to adult care frequently do not obtain medical care until they have severe medical problems.  In addition, these young people struggle to care for their diabetes resulting in unnecessary hospitalizations and premature onset of diabetes-related complications.  The goal of this project is to improve the transition of adolescents and young adults with diabetes to adult medical care.  The intervention will focus on changing behaviors of medical providers caring for youth with diabetes.  If successful, this intervention could decrease hospitalizations, loss to medical care, and complications in adolescents and young adults transitioning from pediatric to adult medical care.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

Improved medical follow up after the transition to an adult diabetes doctor could decrease the risk of hospitalizations and early diabetes-related complications.

Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?

Since beginning my training, I have been drawn to working with patients with diabetes and their families.  Diabetes substantially impacts their lives on a daily basis, and I would like to discover ways to make their efforts easier and more successful.  The adolescent and young adult population is of particular interest to me.  Adolescence is full of multiple challenges for any youth, but this time period is even more challenging for those with diabetes.  I want to learn how we can make this time period easier for adolescents and their families.  I think the provider-patient relationship is one key to improving diabetes management for this age group.  This award will allow me to investigate whether additional education and training for pediatric diabetes providers regarding the transition process will result in improved outcomes in their adolescent patients.  This project will lead to additional research questions regarding long term outcomes in patients following the transition to adult medical care.  Information gained from the study will give insight into future interventions, potential markers of successful or unsuccessful transition of care, and barriers to successful transition.  If education of providers results in more successful transition of pediatric patients to adult medical care, similar educational interventions could be completed in adult diabetes providers to improve retention of adolescent and young adult patients once they transition to adult diabetes care.

In what direction do you see the future of diabetes research going?

This project will lead to additional research questions regarding long term outcomes in patients following the transition to adult medical care.  Information gained from the study will also give insight into future interventions, potential markers of successful or unsuccessful transition of care, and barriers to successful transition.  If education of providers results in more successful transition of diabetes medical care, similar educational interventions could be completed in adult diabetes providers to improve retention of adolescent and young adult patients once they transition to adult diabetes care.