The complexity of transition of paediatric patients to adult care is well recognised, with a multidisciplinary approach widely agreed to be essential. In practice, however, many obstacles still exist for patients, their families, and practitioners alike.
Many endocrine conditions have a genetic or epigenetic basis, but childhood-onset acquired conditions may also have highly specific and complex presentations that evolve over time. These may be less familiar to adult practitioners, particularly given the breadth and volume of adult endocrinology, and with dual expertise in paediatric and adult practice becoming increasingly rare. Barriers to effective communication between paediatric and adult practitioners need to be addressed, both at individual and systems level, in order to optimise continuity of care.
With a rapidly increasing number of childhood cancer survivors filtering into adult clinics, care and surveillance for late effects of cancer therapies represents a growing – and relatively recent - challenge for effective transition. The complexity, interaction, and ongoing evolution of endocrinopathies in these patients is compounded by neurocognitive, psychosocial, and physical comorbidities, which impact their capacity to engage and follow through with care. In this session, clinical knowledge gaps, potential practical pitfalls, and management strategies for both paediatric and adult clinicians will be discussed, highlighting aspects that may be unfamiliar in adult practice.