58 - Improving Transition of Care in Pediatric Patients with Chronic Kidney Disease: A Single Center Pilot Project

Poster Number: 58
Publication Number: 58.35

Melvin Chan, University of Colrado, Denver, CO, United States; Eric Benz, University of Colorado School of Medicine, Aurora, CO, United States; Sarah E. Young, University of Colorado School of Medicine, Denver, CO, United States; Melisha Hanna, University of Colorado School of Medicine, Aurora, CO, United States

Background: Healthcare transition is the process of preparing a pediatric patient for the adult model of care. This process entails identifying the strengths and weaknesses of a patient’s self-management skills and collaborating with him/her/them to improve those weaknesses. There are limited studies on the predictors of transition readiness in the pediatric chronic kidney disease (CKD) population, stages 2-5.

Objective: The goal of this study is to evaluate predictors of transition readiness in pediatric CKD.

Design/Methods: This project started in June 2022 to improve transition of care based on parental requests. Study eligibility criteria include age 14 years old and over, diagnosis of chronic kidney disease stage 2 or higher, and seen in the kidney clinic within the last 6 months. Patients were excluded if they had received a kidney transplant, were on dialysis patients, or had intellectual disability.
Eligible patients were given the Transition Readiness Assessment Questionnaire (TRAQ), a validated tool for evaluating transition readiness. Additionally, socioeconomic variables (race, ethnicity, age, insurance type, and county of residence poverty level based on Census data), CKD stage, and medical utilization over the last year (emergency room visits, clinic visits, hospitalizations, and average length of stay) were recorded. Multivariable linear regression analysis was used to evaluate the relationship between TRAQ scores and patient characteristics.

Results: 53 patients were given the TRAQ questionnaire, with 27 (51%) of them completing the survey.  Table 1 illustrates the clinical characteristics of our population. Older patients were associated with higher total TRAQ Score (β=6.05, p=0.02) and the appointments sub-scale (β=0.93, p=0.03). Being male was associated with lower scores in the TRAQ appointment (β=-3.32, p=0.02), provider communication (β=-16.37, p=0.02), and tracking health issues (β=-14.61, p=0.03) sub-scales The number of clinics attended was associated with lower scores in the TRAQ appointment (β=-0.358, p=0.01) sub-scales. All of these predictors are shown in Table 2. No associations were seen with the other variables. Figure 1 shows the correlations between male gender and TRAQ sub-sections.

Conclusion(s): Our preliminary data show that age, number of clinics attended, and gender are predictors of transition readiness, similar to previous sub-specialty studies. Previous studies have found age to be a strong predictor in the CKD population, but this study also finds that male gender and number of clinics are risk factors for transition readiness.