Impact of an audit and feedback-based intervention on preparation of adolescents for transition to adult type 1 diabetes care: a multi-center quasi-experimental study

Introduction — Adolescents and young adults (AYA) often report feeling poorly prepared and dissatisfied with the process of transitioning from pediatric to adult type 1 diabetes (T1D) care. We aimed to examine the impact of Bridging the Gap (BTG), an audit and feedback-based intervention, on transition care.

Methods — This is a secondary analysis of survey data collected during a multi-center, quasi-experimental pre-post study comparing self-reported completion of important transition activities and preparedness in AYA with T1D between study periods. AYA who had their final pediatric visit in the first and second study years were in the early- and late-implementation cohorts respectively. BTG was conducted in five pediatric diabetes centres within the Ontario Pediatric Diabetes Network in Ontario, Canada from June 1, 2019 to September 30, 2021. Poisson and Logistic regression models were used to examine differences in the completion of transition activities reported to be important and transition preparedness between time periods.

Results — Survey data from 116/144 (81%) and 73/113 (65%) participants in the early and late cohorts were analyzed. The mean number of important transition activities completed was 13% lower in the late cohort (adjusted rate ratio 0.87; 95% confidence interval 0.76-0.99, p=0.03). In the early cohort, 10.3% of participants reported completing all transition care activities which they felt were important compared to 4.1% in the late cohort.

Conclusions — The intervention did not improve the completion of important transition care activities, although this may have been related to the effects of the pandemic on transition care.