Schraeder K, Allemang B, Felske AN, Scott CM, McBrien KA, Dimitropoulos G, Samuel S. Community based Primary Care for Adolescents and Young Adults Transitioning From Pediatric Specialty Care: Results from a Scoping Review.
J Prim Care Community Health 2022;
13:21501319221084890. [PMID:
35323055 PMCID:
PMC8961382 DOI:
10.1177/21501319221084890]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background:
Ongoing primary care during adolescence is recommended by best practice
guidelines for adolescents and young adults (AYAs; ages 12-25) with chronic
conditions. A synthesis of the evidence on the roles of Primary Care
Physicians (PCPs) and benefits of primary care is needed to support existing
guidelines.
Methods:
We used Arksey and O’Malley’s scoping review framework, and searched
databases (MEDLINE, EMBASE, PsychINFO, CINAHL) for studies that (i) were
published in English between 2004 and 2019, (ii) focused on AYAs with a
chronic condition(s) who had received specialist pediatric services, and
(iii) included relevant findings about PCPs. An extraction tool was
developed to organize data items across studies (eg, study design,
participant demographics, outcomes).
Results:
Findings from 58 studies were synthesized; 29 (50%) studies focused
exclusively on AYAs with chronic health conditions (eg, diabetes, cancer),
while 19 (33%) focused exclusively on AYAs with mental health conditions.
Roles of PCPs included managing medications, “non-complex” mental health
conditions, referrals, and care coordination, etc. Frequency of PCP
involvement varied by AYAs; however, female, non-Black, and older AYAs, and
those with severe/complex conditions appeared more likely to visit a PCP.
Positive outcomes were reported for shared-care models targeting various
conditions (eg, cancer, concussion, mental health).
Conclusion:
Our findings drew attention to the importance of effective collaboration
among multi-disciplinary specialists, PCPs, and AYAs for overcoming multiple
barriers to optimal transitional care. Highlighting the need for further
study of the implementation of shared care models to design strategies for
care delivery during transitions to adult care.
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