The Challenges of Transition from Pediatric to Adult Care of Individuals with Sickle Cell Disease

Purpose: Sickle Cell Disease (SCD) used to be considered a childhood disorder, but with earlier diagnosis and more effective treatments, a large majority of patients with SCD are living past 18 years of age. This has created challenges regarding transition of care from pediatric to adult care. Tarrant County itself has seen a rise in adult SCD patients visiting Emergency Departments when compared to Dallas County. The purpose of this project is to present the need for comprehensive care for adults with SCD in Fort Worth and to propose possible options on how to implement an effective transition program. Methods: A website, gottransition.org, was used to collect information on steps for an effective transition. A comprehensive online review was also done to collect information on established and successful adult sickle cell programs in the United States. Results: The Six Core Elements, proposed by gottransition.org, is a structured process that can be customized for use and applied to many different types of transition care models and settings. An Adult Sickle Cell Clinic in Milwaukee, Wisconsin and the St Jude-Methodist Transition Clinic in Memphis, Tennessee revealed various details for an effective transition. Conclusion: The increasing number of adult patients with SCD seeking care from emergency departments in Tarrant County has raised the issue about a lack of comprehensive care for these patients. Implementing a successful transition process is dependent on cooperation from both pediatric and adult practices and/or health systems, and the early and ongoing engagement of parents and young adults.