Implementing a Transition Plan for Adolescents with ADHD Transitioning to Adult Care

Background: Annually in the United States approximately 750,000 children with special health care needs transition from pediatric to adult health care. Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and nearly two thirds of children who have symptoms of ADHD in childhood have symptoms that persist to adulthood (Inman et al., 2017). The Child Development Center at a large medical center in northern New Jersey, prior to this project, did not have a transition process or procedure in place to aid providers to successfully prepare adolescent patients with ADHD for transition to adult care. Transition guidelines for those with ADHD who need ongoing support is integral to the successful transition of patients advancing to adult care (Young et al., 2016). The failure to complete transition into an adult service is likely to leave them without ongoing treatment. Project Aim: The aim of this project is to create evidence-based transition guidelines for the providers at the Child Development Center to better prepare patients with ADHD for transition to an adult provider. Methods: The Six Core Elements of Transition, developed by the American Academy of Pediatrics (White & Cooley, 2018), were used as a guide to develop transition guidelines broken down by age for aged 12-21 years with ADHD at the Child Development Center. An educational session was created and directed to providers to discuss new transition guidelines and introduce resources for the providers and patients. Providers include all physicians (n=3) and nurse practitioners (n=6) at the Child Development Center. Providers were asked to document discussion of transition in their visit summary notes and implement the transition guidelines. Patient charts were examined retrospectively for all patients aged 12-21 years with a diagnosis of ADHD. The charts were examined both pre and post educational session to assess for documented discussion regarding transition and utilization of the guidelines and resources. Results: A total of 365 patients ages 12-21 years with a diagnosis of ADHD were seen in the months of January and February 2024, during the pre-education session period. Of these patients, 19 charts or 5.2% of them had documented conversation in visit notes about transition. A total of 186 patients ages 12-22 years with a diagnosis of ADHD were seen in the month of May 2024, during the post education session period. Of these patients, 87 charts or 46.8% had documented conversation in visit notes about transition. Conclusions: Chi-square test p-value was