Impact of an Audit and Feedback-based Intervention on Preparation of Adolescents for Transition to Adult Type 1 Diabetes Care: A Multicentre Quasi-experimental Study

OBJECTIVES: Adolescents and young adults (AYA) often report feeling poorly prepared and dissatisfied with the process of transitioning from pediatric to adult type 1 diabetes (T1D) care. In this study we aimed to identify the impact of Bridging the Gap (BTG), an audit and feedback-based intervention, on transition care. METHODS: This investigation was a secondary analysis of survey data collected during a multicentre, quasi-experimental pre/post study comparing self-reported completion of important transition activities and preparedness among AYA with T1D between study periods. AYA who had their final pediatric visit in the first and second study years were in the early- and late-implementation cohorts, respectively. BTG was conducted at 5 pediatric diabetes centres within the Ontario Pediatric Diabetes Network in Ontario, Canada, from June 1, 2019, to September 30, 2021. Poisson and logistic regression models were used to examine differences in the completion of transition activities reported to be important and transition preparedness between time periods. RESULTS: Survey data from 116 of 144 (81%) and 73 of 113 (65%) participants in the early and late cohorts were analyzed. The mean number of important transition activities completed was 13% lower in the late cohort (adjusted rate ratio 0.87, 95% confidence interval 0.76 to 0.99, p=0.03). In the early cohort, 10.3% of participants reported completing all transition care activities that they considered important compared with 4.1% in the late cohort. CONCLUSIONS: The intervention did not improve the completion of important transition care activities, although this may have been related to effects of the COVID-19 pandemic on transition care.