Alberta’s Transition Navigator Trial, TNT

A randomized controlled trial evaluating a patient navigator service to improve the transition from pediatric to adult care.

Transition to adult care is a challenging process for youth with special health care needs. Many patients and families feel unprepared for transfer and can struggle to adapt to adult health care settings, reporting difficulties accessing needed services to manage their health conditions.

Likewise, adult care providers feel unprepared to care for transferred patients, lacking resources and time to manage the complexity of their medical needs.

Due to variable, uncoordinated and fragmented transitional care, transferred patients are more likely to experience:

• Loss to follow-up
• Increase in co-morbidities
• Irreversible health deterioration
• Increase in expensive emergency care

The Transition Navigator Trial (TNT) is a pragmatic randomized controlled trial evaluating the effectiveness of a patient navigator versus usual care to improve transition outcomes among adolescents.

Inclusion Criteria	Exclusion Criteria
16–21 years old Has a chronic medical condition Transferring to adult specialty care Transferring within the next 12 months	Non-resident of Alberta Planning to move out of Alberta in next 2 years Enrolled in another transition study with a navigator Not transferring during the study period

We will compare heath care utilization, transition readiness scores and patient-reported health status to understand their experience during transition. We will conduct interviews with participants and stakeholders to understand perceptions of the role of navigators in reducing barriers to care during transition. Lastly, we will evaluate the health care cost impact related to the navigator intervention.

The navigator service will provide patient-oriented care during transition to adult care following recommended clinical practice guidelines. The navigator will focus on:

• preparing for transfer
• reducing social and economic barriers to healthcare
• serving as a health system broker
• promoting self-management

A strong provincial team with leaders in transition research and service delivery was assembled for this study. The principal investigators are Dr. Susan Samuel, a pediatric nephrologist, Dr. Andrew Mackie, a pediatric cardiologist and Dr. Gina Dimitropoulos, an Assistant Professor with the Faculty of Social Work at University of Calgary.

This study will provide urgently needed data to guide providers and policy makers regarding providing coordinated transitional care, directly addressing the call to action in the 2016 Canadian Association of Pediatric Health Centres Guideline for transition. It will benefit the growing vulnerable population of young adults living with chronic health conditions. The results will have the potential to change care delivery, improve health outcomes and experiences of young adults transitioning to adult care.

Information on the Transition Navigator Trial

If you are interested in participating in this trial, you can enrol in Calgary at tnt@ucalgary.ca or in Edmonton at tntrial@ualberta.ca. You may also learn more at Transition Navigator Trial.

This study has been approved by the University of Calgary Conjoint Health Research Ethics Board. Study ID: REB16-2561 and by the University of Alberta Health Research Ethics Board (Pro00077325)

Source The Transition Navigator Trial (TNT)

Also see
Vital People: Transition to adulthood a challenge for youth in care in THe Times Colonist