So hard to say goodbye: Transition from paediatric to adult cardiology care

Important medical advances have created a large and growing population of adults who were diagnosed with congenital or paediatric-onset cardiovascular conditions as children and now require specialized cardiac care as adults. Although some adult patients continue to be cared for by paediatric cardiology programmes, guidelines recommend that patients transfer from paediatric to adult care at 18-21 years of age. Unfortunately, lapses in care during the transfer period are common and associated with poor health outcomes. Comprehensive transition programmes are necessary to maintain continuity of care and effectively prepare adolescents and young adults for the differences between paediatric and adult cardiac care programmes. Transition, unlike transfer, is an extended process that begins during childhood or early adolescence and focuses on patient education and fostering self-management skills and appropriate interdependence. The perspectives of patients, families, and care providers should be recognized and incorporated into transition programmes, and should be used to adapt strategies to meet the needs of individual patients and families. This Review summarizes the current knowledge on the transition of young patients from paediatric to adult cardiology care from the perspectives of all stakeholders, and offers practical recommendations for the development of transition programmes.