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Adherence to transition guidelines in European paediatric nephrology units

(2014) PEDIATRIC NEPHROLOGY. 29(9). p.1617-1624
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Abstract
There is increasing focus on the problems involved in the transition and transfer of young adult patients from paediatric to adult renal units. This situation was addressed by the 2011 International Pediatric Nephrology Association/International Society of Nephrology (IPNA/ISN) Consensus Statement on transition. We performed a survey of transition practices of 15 paediatric nephrology units across Europe 2 years after publication of the consensus statement. Two thirds of units were aware of the guidelines, and one third had integrated them into their transition practice. Forty-seven per cent of units transfer five or fewer patients with chronic kidney disease (CKD) stage 5 per year to a median of five adult centres, with higher numbers of CKD stages 2-4 patients. Seventy-three per cent of units were required by the hospital or government to transfer patients by a certain age. Eighty per cent of units commenced transition planning after the patient turned 15 years of age and usually within 1-2 years of the compulsory transfer age. Forty-seven per cent of units used a transition or transfer clinic. Prominent barriers to effective transition were patient and parent attachment to the paediatric unit and difficulty in allowing the young person to perform self-care. Whereas awareness of the consensus statement is suboptimal, it has had some impact on practice. Adult nephrologists receive transferred patients infrequently, and the process of transition is introduced too late by paediatricians. Government- and hospital-driven age-based transfer policies distract focus from the achievement of competencies in self care. Variable use of transition clinics, written patient information and support groups is probably due to economic and human-resource limitations. The consensus statement provides a standard for evolving and evaluating transition policies jointly agreed upon by paediatric and adult units.

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MLA
Forbes, Thomas A, Alan R Watson, Aleksandra Zurowska, et al. “Adherence to Transition Guidelines in European Paediatric Nephrology Units.” PEDIATRIC NEPHROLOGY 29.9 (2014): 1617–1624. Print.
APA
Forbes, T. A., Watson, A. R., Zurowska, A., Shroff, R., Bakkaloglu, S., Vondrak, K., Fischbach, M., et al. (2014). Adherence to transition guidelines in European paediatric nephrology units. PEDIATRIC NEPHROLOGY, 29(9), 1617–1624.
Chicago author-date
Forbes, Thomas A, Alan R Watson, Aleksandra Zurowska, Rukshana Shroff, Sevcan Bakkaloglu, Karel Vondrak, Michel Fischbach, et al. 2014. “Adherence to Transition Guidelines in European Paediatric Nephrology Units.” Pediatric Nephrology 29 (9): 1617–1624.
Chicago author-date (all authors)
Forbes, Thomas A, Alan R Watson, Aleksandra Zurowska, Rukshana Shroff, Sevcan Bakkaloglu, Karel Vondrak, Michel Fischbach, Johan Vande Walle, Gema Ariceta, Alberto Edefonti, Christoph Aufricht, Augustina Jankauskiene, Tuula Holta, Mesiha Ekim, Claus Peter Schmitt, and Constantinos Stefanidis. 2014. “Adherence to Transition Guidelines in European Paediatric Nephrology Units.” Pediatric Nephrology 29 (9): 1617–1624.
Vancouver
1.
Forbes TA, Watson AR, Zurowska A, Shroff R, Bakkaloglu S, Vondrak K, et al. Adherence to transition guidelines in European paediatric nephrology units. PEDIATRIC NEPHROLOGY. 2014;29(9):1617–24.
IEEE
[1]
T. A. Forbes et al., “Adherence to transition guidelines in European paediatric nephrology units,” PEDIATRIC NEPHROLOGY, vol. 29, no. 9, pp. 1617–1624, 2014.
@article{4379083,
  abstract     = {There is increasing focus on the problems involved in the transition and transfer of young adult patients from paediatric to adult renal units. This situation was addressed by the 2011 International Pediatric Nephrology Association/International Society of Nephrology (IPNA/ISN) Consensus Statement on transition. 
We performed a survey of transition practices of 15 paediatric nephrology units across Europe 2 years after publication of the consensus statement. 
Two thirds of units were aware of the guidelines, and one third had integrated them into their transition practice. Forty-seven per cent of units transfer five or fewer patients with chronic kidney disease (CKD) stage 5 per year to a median of five adult centres, with higher numbers of CKD stages 2-4 patients. Seventy-three per cent of units were required by the hospital or government to transfer patients by a certain age. Eighty per cent of units commenced transition planning after the patient turned 15 years of age and usually within 1-2 years of the compulsory transfer age. Forty-seven per cent of units used a transition or transfer clinic. Prominent barriers to effective transition were patient and parent attachment to the paediatric unit and difficulty in allowing the young person to perform self-care. 
Whereas awareness of the consensus statement is suboptimal, it has had some impact on practice. Adult nephrologists receive transferred patients infrequently, and the process of transition is introduced too late by paediatricians. Government- and hospital-driven age-based transfer policies distract focus from the achievement of competencies in self care. Variable use of transition clinics, written patient information and support groups is probably due to economic and human-resource limitations. The consensus statement provides a standard for evolving and evaluating transition policies jointly agreed upon by paediatric and adult units.},
  author       = {Forbes, Thomas A and Watson, Alan R and Zurowska, Aleksandra and Shroff, Rukshana and Bakkaloglu, Sevcan and Vondrak, Karel and Fischbach, Michel and Vande Walle, Johan and Ariceta, Gema and Edefonti, Alberto and Aufricht, Christoph and Jankauskiene, Augustina and Holta, Tuula and Ekim, Mesiha and Schmitt, Claus Peter and Stefanidis, Constantinos},
  issn         = {0931-041X},
  journal      = {PEDIATRIC NEPHROLOGY},
  language     = {eng},
  number       = {9},
  pages        = {1617--1624},
  title        = {Adherence to transition guidelines in European paediatric nephrology units},
  url          = {http://dx.doi.org/10.1007/s00467-014-2809-4},
  volume       = {29},
  year         = {2014},
}

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