D1.417 - A review of healthcare transition of young people aged 16-18 years old seen in a tertiary paediatric allergy service

Developmentally appropriate care and healthcare transition are key to enabling young people to learn self-management of allergic conditions. Healthcare professionals need to support this process. 

A retrospective service evaluation reviewing case notes of young adults aged 16-18 years seen in a tertiary paediatric allergy service in London, UK, in a 12-month period (2023) against standards from EAACI and National Institute for Health and Care Excellence (NICE) guidelines on transition. 

n=484 patients had booked appointments; 45.2% (219) attended; 10.7% (52) did not attend, other appointments rescheduled. 105/219 randomly selected patients who attended included (n=35 age 16, n=35 age 17, n=35 age 18; 52.4% male). 70.5% had > 1 allergic condition. The majority (69.5%; 73/105) had food allergies, with 39.7% (29/73) having > 6 food allergies. Allergic co-morbidities or other diagnoses included: 69.5% allergic rhinitis, 41.9% asthma, 36% eczema, 7.6% pollen food syndrome, 5.7% drug allergy, and 1.9% insect allergy.

The majority (88.6%) were seen in a general paediatric allergy clinic and only 17.1% were seen in a dedicated adolescent clinic. Many patients had a mix of face-to-face and telephone appointments (58.1%). 

Most young people (75.2%) were present and active during their last appointment. Documentation of transition specific topics was sparse: transition services discussed (23.8%), signposting to specific resource (15.2%;  www.11to25hub.com or others) transition information given (7.6%). Letters were addressed to the young person in only 10.5%. Access to personal health-records (electronic portal) were discussed in 9.5%. Of those being discharged from the service: 62.9% were discharged to their GP, 18.1% had further paediatric follow-up and 15 patients (14.3%) were referred to the adult allergy services (4 attended, 8 pending appointments, 2 external referrals, 1 not attended/rescheduled). Of these 15 patients, only 9 (60%) had documented transition reports.

Our results highlight real-world challenges to good transition practice even in a service with high awareness of the transition process, with lacking documentation, frequent appointment rescheduling and low rates of referral to adult allergy services, even in a cohort with allergic multimorbidity. This highlights the need for ongoing education to embed transition practice into everyday care and practical resources to support this process.