Evidence map›Paper›PMID 42648749›Full record

ArticleBMJ open quality2026

Growing pains: adult subspecialist perspectives on improving transition from paediatric to adult care for youth with complex health conditions.

Sarah Malecki, Chioma Nwebube, Julia Orkin, Ilana Halperin, Naba Khan, Tomisin John, Hans Katzberg, Amanda Steiman, Rano Matta, Tarek Abdelhalim and 24 more

Abstract read
In one paragraph

Article in BMJ open quality, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Sarah MaleckiChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-3457-0696
Chioma NwebubeChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Julia OrkinChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Ilana HalperinUniversity of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada.
Naba KhanChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Tomisin JohnChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Hans KatzbergDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Amanda SteimanDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Rano MattaDepartment of Surgery, Division of Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Tarek AbdelhalimDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Danielle M AndradeDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Natasha BollegalaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Shaelynne BushComplex Care Program, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Clodagh RyanDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Kimberly ColapintoComplex Care Program, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Eleni DimarakiDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Hanna FaghfouryDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Jennifer FuDepartment of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Natasha GakhalDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Kate GentDepartment of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Chana KorenblumDepartment of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Perla LansangDivision of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Iliana C LegaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mary Jane Lim-FatDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Jessica LiuDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-1545-1560
Susan MirandaComplex Care Program, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Geetha MukerjiDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Christian PagnouxDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Eryn VandepoeleDepartment of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Ophir VinikDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Karla WentzelDepartment of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Darryl YatesBrain and Mental Health Services, The Hospital for Sick Children, Toronto, Ontario, Canada.
Eyal CohenChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Alene ToulanyChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada alene.toulany@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransition from paediatric to adult healthcare is particularly challenging for youth and their caregivers with complex health conditions, in part due to loss of paediatric supports and fragmentation of care, contributing to adverse outcomes. To date, transition research and policy has been largely driven by paediatric providers. Adult provider insights are critical to inform gaps in care, transition planning and enable innovative and sustainable interventions.

objectiveTo describe adult subspecialist perspectives on barriers, facilitators and opportunities to improve the transition from paediatric to adult care for youth with complex health conditions.

methodsAn adult subspecialty advisory panel was convened as part of a quality improvement initiative, with physicians from the University of Toronto's Department of Medicine who participated in three virtual meetings through nomination and stakeholder mapping. The first meeting focused on identifying current challenges and opportunities in transition to adult care; the second generated recommendations based on experiential knowledge and the third reviewed case studies to identify gaps and potential solutions. Discussions were recorded, transcribed and analysed using thematic qualitative analysis.

resultsAdult subspecialists identified five key areas for improvement: (1) preparing patients and families for the realities of adult care; (2) bridging communication gaps between paediatric and adult systems; (3) moving beyond age-based transition toward flexible, readiness-informed care; (4) strengthening collaboration among adult providers caring for young adults; and (5) addressing structural and infrastructure barriers within adult care systems.

conclusionAdult care physicians expressed and validated that young adults have unique care needs during their transition to adult care. They highlighted the need for stronger cross-system collaboration, resources and investment to ensure effective transition. These findings highlight barriers in implementing current paediatric-led transition standards and provide a foundation for system-level, disease-agnostic approaches to improve continuity of care across the paediatric-adult divide.

Indexed as

PhysiciansTransition to Adult CareAdolescentAdultHumansPediatricsQualitative ResearchQuality ImprovementAdolescentChronic disease managementComplexityTransition to Adult Care

Identifiers

PMID42648749
PMCPMC13536146

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.