Transitioning Youth from Paediatric to Adult Care: Knowledge, Practice and Perceptions of Paediatricians and Adult Physicians in Malta

Background: Implementing an adolescent transition programme improves the clinical outcome of young persons with chronic conditions and reduces morbidity and mortality. There is no official adolescent transitional programme in Malta at present.

Objectives: To assess the knowledge, practice and perception of paediatricians and adult physicians regarding adolescent transitional care in Malta and to identify any barriers before a transitional programme can be implemented.

Methods: A mixed method approach was used. A modified questionnaire was developed from questionnaire tools in the literature. It was piloted and validated locally before being distributed to paeditricians and adult physicians at BST, HST, RS and consultant level in both departments. Descriptive analysis was applied. Semi-structured interviews were subsequently conducted and transcribed ad verbatim. Thematic analysis of the interview transcripts was conducted.

Results: The response rate for the questionnaire was 48.6% from adult physicians and 85.5% from paediatricians. 74% of paediatricians and 82% of adult physicians have no training in ATC. Lack of training was the most significant barrier together with lack of clinic time, lack of resources and lack of a formalised transition policy. Interview analysis showed similarities with the findings of the questionnaire but conflicting views emerged regarding the role of the GP, whether provision of ATC is superior in the private sector or at MDH and the management of YP with a particular chronic condition in Malta. All the interviewees agreed on the importance of developing a standardised transition policy.

Conclusions: This is the first study exploring ATC in Malta. There are unmet education and training needs of paediatricians and adult physicians and a standardised adolescent transition care policy is needed.

A set of recommendations applicable to the Maltese system were drawn up from the results of this study that can help to set up an adolescent transitional care programme in Malta.

ATC - adolescent transitional care

GP - general practitioner

YP - young person

MDH - Mater Dei Hospital Malta