Uncharted Territory: Systematic Review of Providers' Roles, Understanding, and Views Pertaining to Health Care Transition 1

• Ninety percent of AEA with special health care needs are expected to survive into the second decade of life.
• The challenges in the developing field of HCT practice are formidable as both pediatric and adult providers are expected to develop new repertoire of intergenerational knowledge and skills.
• Study findings cluster according to four themes: I think these should be capitalized with Italics: Adult Provider Competency, Provider Perspectives, Provider Attitudes and HCT Service Models adult provider competency, provider perspectives, provider attitudes, and HCT service models.
• Review findings demonstrate the lack of evidence available on the issues and needs of providers involved in providing HCT services.
• Evidence is lacking due to the significant limitations of the research conducted to date.

BackgroundHealth care transition (HCT) for adolescents and emerging adults (AEA) with special health care needs is an emerging field of interdisciplinary field of practice and research that is based upon an intergenerational approach involving care coordination between pediatric and adult systems of health care. Informed understanding of the state of the HCT science pertaining to this group of providers is needed in order to develop and implement service programs that will meet the comprehensive needs of AEA with special health care needs.MethodsThe authors conducted a systematic review of the literature on the transition from child to adult care for adolescents and emerging adults (AEA) with special health care needs from 2004 to 2013. Fifty-five articles were selected for this review. An adaptation of the PRISMA guidelines was applied because all studies in this review used descriptive designs.ResultsFindings revealed lack of evidence due to the limitations of the research designs and methodology of the studies included in this systematic review. Study findings were categorized the following four types: adult provider competency, provider perspectives, provider attitudes, and HCT service models. The discipline of medicine was predominant; interdisciplinary frameworks based upon integrated care were not reported. Few studies included samples of adult providers.ConclusionsEmpirical-based data are lacking pertaining to the role of providers involved in this specialty area of practice. Evidence is hampered by the limitations of the lack of rigorous research designs and methodology.