2023-09-28 14:46:10 +00:00
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abstract: 'Background Ageing into adulthood is challenging at baseline, and doing
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so with a chronic disease can add increased stress and vulnerability.
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Worldwide, a substantial care gap exists as children transition from
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care in a paediatric to adult setting. There is no current consensus on
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safe and equitable healthcare transition (HCT) for patients with chronic
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disease in resource-denied settings. Much of the existing literature is
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specific to HIV care. The objective of this narrative review was to
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summarise current literature related to adolescent HCT not associated
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with HIV, in low-income and middle-income countries (LMICs) and other
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resource-denied settings, in order to inform equitable health policy
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strategies. Methods A literature search was performed using defined
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search terms in PubMed and Cumulative Index to Nursing and Allied Health
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Literature databases to identify all peer-reviewed studies published
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until January 2020, pertaining to paediatric to adult HCT for
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adolescents and young adults with chronic disease in resource-denied
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settings. Following deduplication, 1111 studies were screened and
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reviewed by two independent reviewers, of which 10 studies met the
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inclusion criteria. Resulting studies were included in thematic analysis
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and narrative synthesis. Results Twelve subthemes emerged, leading to
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recommendations which support equitable and age-appropriate adolescent
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care. Recommendations include (1) improvement of community health
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education and resilience tools for puberty, reproductive health and
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mental health comorbidities; (2) strengthening of health systems to
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create individualised adolescent-responsive policy; (3) incorporation of
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social and financial resources in the healthcare setting; and (4)
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formalisation of institution-wide procedures to address
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community-identified barriers to successful transition. Conclusion
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Limitations of existing evidence relate to the paucity of formal policy
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for paediatric to adult transition in LMICs for patients with
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childhood-onset conditions, in the absence of a diagnosis of HIV. With a
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rise in successful treatments for paediatric-onset chronic disease,
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adolescent health and transition programmes are needed to guide
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effective health policy and risk reduction for adolescents in
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resource-denied settings.'
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affiliation: 'Ratner, L (Corresponding Author), Harvard Med Sch, Div Resp Med, Boston
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Childrens Hosp, Boston, MA 02115 USA.
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Ratner, L (Corresponding Author), Brigham \& Womens Hosp, Div Gen Internal Med,
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Boston, MA 02115 USA.
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Narla, Nirmala Priya; Russ, Christiana M., Harvard Med Sch, Div Med Crit Care, Boston
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Childrens Hosp, Boston, MA USA.
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Narla, Nirmala Priya, Univ Texas Hlth Sci Ctr Houston, Dept Pediat, Houston, TX
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USA.
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Ratner, Leah, Harvard Med Sch, Div Resp Med, Boston Childrens Hosp, Boston, MA 02115
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USA.
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Ratner, Leah, Brigham \& Womens Hosp, Div Gen Internal Med, Boston, MA 02115 USA.
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Bastos, Fernanda Viera, Hosp Clin Univ Sao Paolo, Med Sch, Sao Paulo, Brazil.
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Owusu, Sheila Agyeiwaa; Osei-Bonsu, Angela, Komfo Anokye Teaching Hosp, Directorate
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Child Hlth, Kumasi, Ghana.'
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article-number: e001059
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author: Narla, Nirmala Priya and Ratner, Leah and Bastos, Fernanda Viera and Owusu,
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Sheila Agyeiwaa and Osei-Bonsu, Angela and Russ, Christiana M.
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author-email: Leah.Ratner@childrens.harvard.edu
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author_list:
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- family: Narla
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given: Nirmala Priya
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- family: Ratner
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given: Leah
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- family: Bastos
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given: Fernanda Viera
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- family: Owusu
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given: Sheila Agyeiwaa
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- family: Osei-Bonsu
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given: Angela
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- family: Russ
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given: Christiana M.
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da: '2023-09-28'
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doi: 10.1136/bmjpo-2021-001059
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eissn: 2399-9772
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files: []
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journal: BMJ PAEDIATRICS OPEN
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keywords: adolescent health; social work; health services research
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keywords-plus: ADOLESCENTS; YOUTH; DISABILITIES; VALIDATION; READINESS; SERVICES;
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NEEDS
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language: English
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number: '1'
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number-of-cited-references: '29'
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orcid-numbers: 'Owusu, Sheila Agyeiwaa/0000-0002-5172-2842
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Narla, Nirmala/0000-0002-6152-9245
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Vieira Bastos, Fernanda/0009-0007-2037-8720
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Osei-Bonsu, Angela/0000-0002-0468-1160
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Ratner, Leah/0000-0001-6326-3543'
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papis_id: ed9ea126fea3cebae20c133f563da584
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ref: Narla2021paediatricadult
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researcherid-numbers: 'Owusu, Sheila Agyeiwaa/AAE-8025-2022
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owusu, Sheila Agyeiwaa/ITT-2132-2023
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'
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tags:
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- review
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times-cited: '11'
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title: 'Paediatric to adult healthcare transition in resource-limited settings: a
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narrative review'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000642174300001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '4'
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volume: '5'
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web-of-science-categories: Pediatrics
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year: '2021'
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