The Impact of Age of Transfer on Outcomes in the Transition From Pediatric to Adult Health Systems: A Systematic Review of Reviews

Arrash Yassaee, Daniel R. Hale, Alice Armitage, Russell M. Viner

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)
99 Downloads (Pure)


International guidance on health-care transition has existed for over a decade; however, many unanswered questions remain. This systematic review of reviews aimed to answer the question: is a later age of transfer from pediatric to adult health care associated with improved health and health service outcomes?

We included systematic reviews which considered at least one long-term condition and provided outcome data from adult services. Methodology of primary studies was not an exclusion criterion. We searched multiple databases and conducted an initial search in May 2015 which was repeated in May 2017. All reviews were assessed for quality using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) tool. Reviews that scored less than 22 were excluded.

Initial searches identified 6,149 papers. Forty-three reviews met exclusion and inclusion criteria, and 15 reviews also met quality criteria. With one exception, primary studies from reviews which only considered quantitative evidence found that a delayed age of transfer resulted in improved outcomes. Qualitative and mixed-methods evidence supported the view that age 18 was an appropriate time of transfer.

We found moderate evidence that models of transition which transfer young people in late adolescence or early adulthood can improve transition outcomes and patient satisfaction.
Original languageEnglish
Pages (from-to)709-720
Number of pages12
JournalJournal of Adolescent Health
Issue number6
Early online date2 Mar 2019
Publication statusPublished - Jun 2019


  • Adolescent
  • Chronic condition
  • Health-care transition
  • Long-term condition
  • Systematic review
  • Transfer
  • Transition

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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