Introduction
Cystic fibrosis (CF) is one of the most frequent severe genetic diseases, with 6757 patients included in the French CF Registry in 2017 (1). The prognosis of CF has improved greatly thanks to early diagnosis and specific treatments and the establishment of specific CF centers. These improvements have led to significant demographic changes. Since 2013 in France, more than half of the French CF population are adults, indicating that almost all the pediatric CF patients have gone through the process of transition from a pediatric to an adult CF center. This phenomenon will continue to grow in the years to come. Transition between the pediatric and adult healthcare system is defined as “the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health (2). This period is described as a risky period, with potential complications or clinical degradation, which can include unsteadiness in young diabetic patients, solid organ transplantation rejection in young transplanted patients, and loss of follow-up in young patients with congenital cardiomyopathies or cancer (3). According to the systematic review of Crowley and al., limitation of transition complications in adolescents with chronic conditions is linked to specific transition clinics and the patient’s education.
Currently, in France, there is no recommended national transition program for CF patients (4). Worldwide, practices for CF patient transfer are disparate. In Canada, a transition process has existed in some hospitals since 1982 (5), Australia and the US have been developing transition procedures for many years, and Australia has dedicated adult clinics for CF with positive results (6, 7). Focusing on Europe, the United Kingdom was a pioneer in the transition for patients with CF, with well-defined NHS protocols for years (8,9). Conversely, Germany and Denmark have no official transition programs for CF, but some studies on short-term program transitions have shown encouraging results within the past few years (11, 12).
Studies on transfer in CF mainly focus on subjective criteria and psychological criteria. Our study aimed to evaluate a ten-year-old, formalized transition process from a pediatric to an adult CF center in Lyon and observed its impact on the patients’ clinical evolution.