Grant: Operating Grant: SPOR PIHCI Network: Quick Strikes

During the transition to adult care, patients with Type 1 Diabetes (T1D) risk loss to follow-up care, decreased frequency of clinic attendance, increased rate of diabetes-related hospitalizations, and poorer post-transition glycemic control; all of which can have negative long-term consequences for patients. Although well-coordinated health care services are crucial during this period of a patient's life, there is a good deal of variation in how the transition to adult care is structured across different centres in Canada, with little evidence supporting the adoption of any particular model of transition care. A topic not well explored in relation to diabetes transition is the potential role that primary care can play in improving the transition experience for emerging adults with T1D. Our project has three main parts. First, we will survey the 36 pediatric diabetes centres in Ontario and pediatric diabetes clinics in Newfoundland to explore the current model of transition care services that are being employed. Second, we will link these different models to hospitalization and primary care physician usage data to explore the impact of both transition and the various models of care on patient outcomes. In the third part of the project, we will conduct focus groups with patients with T1D who have recently transitioned into adult care and interview family physicians to discuss their experience with transition and ways that family physicians can play a bigger role supporting youth adults with T1D. It is hoped that this work will give us more information about how patients with T1D are being treated as they move into adult care, that we can identify programs or centres which seem to be doing this better, and identify interventions we can try to improve the experience of young adults with T1D, and may be even for other patients with chronic conditions transferring into adult care.