Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review

Topic overview

Emma J. Moore, Susan M. Sawyer, Sebastian K. King, Melissa Y. Tiena, Misel Trajanovska

Background: Despite surgical advances for complex congenital colorectal conditions, such as anorectalmalformation (ARM) and Hirschsprung disease (HD), many adolescents require transfer from specialistpediatric to adult providers for ongoing care.

Methodology: A systematic review of PubMed, MEDLINE and Embase was conducted to identify what isknown about the transitional care of patients with ARM and HD (PROSPERO # CRD42022281558). ThePreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework guided ourreporting of studies that focused on the transition care of 10e30-year-olds with ARM and HD.

Results: Eight studies were identified that included patient and parent (n¼188), and/or clinician per-spectives (n¼334). Patients and clinicians agreed that transitional care should commence early inadolescence to support transfer to adult care when a suitable level of maturation is reached. There waslittle evidence from patients that transfer happened in a timely or coordinated manner. Patients felt thatclinicians did not always understand the significance of transfer to adult services. No models of transitioncare were identified. Surgeons ranked ARM and HD as the most common conditions to experiencedelayed transfer to adult care. Beyond pediatric surgeons, patients also highlighted the importance ofgeneral practitioners, transitional care coordinators and peer support groups for successful transition.

Conclusions: There is little research focused on transitional care for patients with ARM and HD. Givenevidence of delayed transfer and poor experiences, the development of models of transitional care ap-pears essential.

Intended audience: Healthcare professionals and clinicians.