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Abstract
Objective To explore the methodologies employed in studies assessing transition of care interventions, with the aim of defining goals for the improvement of future studies.
Design Systematic review of comparative studies assessing transition to adult care interventions for young people with chronic conditions.
Data sources MEDLINE, EMBASE, ClinicalTrial.gov.
Eligibility criteria for selecting studies 2 reviewers screened comparative studies with experimental and quasi-experimental designs, published or registered before July 2015. Eligible studies evaluate transition interventions at least in part after transfer to adult care of young people with chronic conditions with at least one outcome assessed quantitatively.
Results 39 studies were reviewed, 26/39 (67%) published their final results and 13/39 (33%) were in progress. In 9 studies (9/39, 23%) comparisons were made between preintervention and postintervention in a single group. Randomised control groups were used in 9/39 (23%) studies. 2 (2/39, 5%) reported blinding strategies. Use of validated questionnaires was reported in 28% (11/39) of studies. In terms of reporting in published studies 15/26 (58%) did not report age at transfer, and 6/26 (23%) did not report the time of collection of each outcome.
Conclusions Few evaluative studies exist and their level of methodological quality is variable. The complexity of interventions, multiplicity of outcomes, difficulty of blinding and the small groups of patients have consequences on concluding on the effectiveness of interventions. The evaluation of the transition interventions requires an appropriate and common methodology which will provide access to a better level of evidence. We identified areas for improvement in terms of randomisation, recruitment and external validity, blinding, measurement validity, standardised assessment and reporting. Improvements will increase our capacity to determine effective interventions for transition care.
- PAEDIATRICS
- PUBLIC HEALTH
- STATISTICS & RESEARCH METHODS
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Footnotes
Contributors ELR conceptualised and designed the study, designed the data collection instruments, collected data, carried out the initial analyses, drafted the initial manuscript, revised the manuscript and approved the final manuscript as submitted. HM collected data, participated in the interpretation of the data, revised the manuscript and approved the final manuscript as submitted. RB and CA provided methodological advices, interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted. SG-C, PJ and SG provided interpretation of data, critically reviewed the manuscript and approved the final manuscript as submitted. CA and ELR are the guarantors for the study.
Funding This project was supported by a grant from the Roche Foundation (contract number 2014RDB010) and by the French Ministry of Health. ELR was also supported by a doctoral contract funded by the UPMC Université Paris 6 Sorbonne Paris Cité.
Competing interests All authors have completed the ICMJE uniform disclosure form (at http://www.icmje.org/coi_disclosure.pdf) and declare: ELR reports grants from UPMC Université Paris 6 Sorbonne Paris Cité, during the conduct of the study. HM reports grants from Pfizer Foundation for child and adolescent health, outside the submitted work. SG reports grants from French Ministry of Health, during the conduct of the study. PJ reports personal fees and non-financial support from Pfizer, outside the submitted work. CA reports grants from Roche Foundation, during the conduct of the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The authors will give full access to our database that gathered data of individual studies included in this review. The request must be done by sending an email to enora.le-roux@inserm.fr.