Transition models of care for Type 1 Diabetes: a systematic review

Transition models of care for Type 1 Diabetes: a systematic review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Transition models of care for Type 1 Diabetes: a systematic review Yvonne Zurynski, Ann Carrigan, Isabelle Meulenbroeks, Mitchell N Sarkies, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2261736/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Jul, 2023 Read the published version in BMC Health Services Research → Version 1 posted 9 You are reading this latest preprint version Abstract Background Managing the care regimen for Type 1 Diabetes (T1D) is challenging for emerging adults, as they take on greater responsibility for self-management. A diverse range of models of care have been implemented to improve safety and quality of care during transition between paediatric and adult services. However, evidence about acceptability and effectiveness of these is limited. Our aim was to synthesize the evidence for transition models and their components, examine the health related and psychosocial outcomes, and to identify determinants associated with the implementation of person-centred models of transition care. Method We searched Medline, CINAHL, EMBASE and Scopus. Peer reviewed empirical studies that focused on T1D models of care published from 2010 to 2021 in English, reporting experimental, qualitative, mixed methods, and observational studies were included. Results Fourteen studies reported on health and psychosocial outcomes, and engagement with healthcare. Three key models of care emerged: structured transition education programs (6 studies), multidisciplinary team (MDT) transition support (5 studies) and telehealth/virtual care as an integral component of a broader model (3 studies). Compared with usual practice, three of the six structured transition education programs led to improved maintenance of glycaemic control, improved psychological well-being, and improved engagement with health services. Four MDT transition care models reported improved health outcomes, and improved engagement with health services, however, three studies reported no benefit. Reduced diabetes related stress and increased patient satisfaction were reported by two studies, but three reported no benefit. Telehealth and virtual group appointments improved adherence to self-management and reduced diabetes distress but no change in health outcomes. No study reported on implementation determinants or applied an implementation framework to guide their research. Conclusions Although some health and psychosocial benefits are reported, the results were mixed. No studies reported on T1D transition model implementation outcomes such as acceptability, adoption, and appropriateness among clinicians or managers implementing these models. This gap needs to be addressed to support future adoption of successful models. type 1 diabetes adolescents transition of care model of care Full Text Additional Declarations No competing interests reported. Supplementary Files Supplementalfile1.docx Supplementalfile2.docx Cite Share Download PDF Status: Published Journal Publication published 20 Jul, 2023 Read the published version in BMC Health Services Research → Version 1 posted Editorial decision: Major revision 10 Mar, 2023 Reviews received at journal 09 Feb, 2023 Reviewers agreed at journal 08 Feb, 2023 Reviewers agreed at journal 08 Feb, 2023 Reviewers invited by journal 08 Feb, 2023 Editor assigned by journal 08 Feb, 2023 Editor invited by journal 01 Feb, 2023 Submission checks completed at journal 01 Feb, 2023 First submitted to journal 11 Nov, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2261736","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":172340961,"identity":"84e4f88b-ef02-495c-b77e-6bdc3fb30aa9","order_by":0,"name":"Yvonne 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"type 1 diabetes, adolescents, transition of care, model of care","lastPublishedDoi":"10.21203/rs.3.rs-2261736/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2261736/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eManaging the care regimen for Type 1 Diabetes (T1D) is challenging for emerging adults, as they take on greater responsibility for self-management. A diverse range of models of care have been implemented to improve safety and quality of care during transition between paediatric and adult services. However, evidence about acceptability and effectiveness of these is limited. \u0026nbsp;Our aim was to synthesize the evidence for transition models and their components, examine the health related and psychosocial outcomes, and to identify determinants associated with the implementation of person-centred models of transition care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe searched Medline, CINAHL, EMBASE and Scopus. Peer reviewed empirical studies that focused on T1D models of care published from 2010 to 2021 in English, reporting experimental, qualitative, mixed methods, and observational studies were included.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFourteen studies reported on health and psychosocial outcomes, and engagement with healthcare. Three key models of care emerged: structured transition education programs (6 studies), multidisciplinary team (MDT) transition support (5 studies) and telehealth/virtual care as an integral component of a broader model (3 studies). Compared with usual practice, three of the six structured transition education programs led to improved maintenance of glycaemic control, improved psychological well-being, and improved engagement with health services. Four MDT transition care models reported improved health outcomes, and improved engagement with health services, however, three studies reported no benefit. Reduced diabetes related stress and increased patient satisfaction were reported by two studies, but three reported no benefit. Telehealth and virtual group appointments improved adherence to self-management and reduced diabetes distress but no change in health outcomes. No study reported on implementation determinants or applied an implementation framework to guide their research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlthough some health and psychosocial benefits are reported, the results were mixed. No studies reported on T1D transition model implementation outcomes such as acceptability, adoption, and appropriateness among clinicians or managers implementing these models. 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