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Table 1 Overview of terms and definitions

From: Discontinuation of follow-up care for young people with complex chronic conditions: conceptual definitions and operational components

Gleeson et al., 2013 [19]

Lost to follow up

stopped attending either paediatric or adult clinics or were discharged because of nonattendance before care could be transferred to another adult service

de Bono et al., 2005 [30]

Lost to follow up

not being seen in any cardiac clinic for a period of at least 2 years

Wacker et al., 2005 [53]

Lost to follow-up

failed to return for a scheduled FU visit for > 5 years

Wray et al., 2013 [54]

Lost to specialist follow up

not been seen within any specialist network in the past 3 years

Gerardin et al., 2016 [32]

Lost to cardiology follow-up

Not seen a cardiologist in an outpatient clinic during the 3 year study period

Bohun et al., 2016 [2]

Lost to follow up

Not seen by any provider in the institution

Agwu et al., 2015 [27]

Lost to follow-up

No primary HIV outpatient provider visits during the 1 year (365 days) after the 22nd birthday.

Trefz et al., 2015 [48]

lost to follow-up

≥3 times no show for outpatient evaluation and/or no blood samples sent for Phe analysis” (Phe = phenylalanine)

Kakkar et al., 2016 [36]

Lost to follow-up

could not be reached

Sawicki et al., 2017 [44]

lost to follow-up

patient without any data in the Registry

Mackie et al., 2009 [6]

Loss of follow-up

Patients who were not seen by a cardiologist within the indicated age range but were seen again by a cardiologist in an older age group or patients who had their last cardiology follow-up at that age.

Mackie et al., 2012 [40]

Loss to follow-up

no return visit to a cardiology clinic for a minimum of 3 years

Pyatak et al., 2017 [41]

Loss to follow-up

The number of routine diabetes care visits (including both paediatric and adult care visits) at the study’s participating clinics during the 12-month study period.

Sam-Agudu et al., 2017 [42]

Retention in care

Having made at least two clinic visits separated by a 6-month period within 12 months and at least four visits each separated by at least 6 months within 24 months post transfer

Steinbeck et al., 2015 [45]

Retention in adult services

The definition of retention in the adult service was: (i) the participant continued to be a patient of the adult diabetologist they were originally referred to; or failing that (ii) the participant successfully transferred to another adult diabetologist

Norris et al., 2013 [7]

Retention in care

any cardiology clinic visit within 2 years of the telephone interview

Gurvitz et al., 2013 [5]

Gap in cardiology care

more than 3 year interval between any cardiology appointments (internal medicine, paediatric or adult congenital cardiology)

Sawicki et al., 2017 [44]

Gap in care

time in days between last recorded encounter at a paediatric or affiliate program and first recorded encounter at an adult program

Sawicki et al., 2017 [44]

Prolonged gap in care

A gap in care in accredited CF centres of greater than or equal to 365 days

Garvey et al., 2012 [31]

(time) Gap

describing post transition gaps in care > 6 months for patients with type 1 diabetes

Mackie et al., 2016 [39]

Excess time between paediatric and ACHD care

The time interval (in months) between the final paediatric visit and the first ACHD visit, minus the recommended time interval between these visits

Wisk et al., 2015 [51]

Transfer gap

time from the last paediatric-focused PCP visit to the first adult-focused PCP visit

Norris et al., 2013 [7]

Lapse in care

Any 2y interval without cardiac care

Valente et al., 2013 [49]

Lapse of care

no direct recorded contact with our adult congenital heart disease (ACHD) centre within the last 3 years

Yeung et al., 2008 [9]

Lapse in medical care

Length of time from leaving care at a paediatric institution to receiving subsequent cardiac care at any institution. A duration since last visit greater than the 2-year

Sattoe et al., 2017 [43]

Successful transition

Indicator 1 – patient not lost to follow-up: It is recorded whether a patient is transferred and to where, and/or a note or letter of transfer of the patient to adult care is found in the electronic patient record (EPR) (yes/no). Those who score ‘no’ are no longer seen in paediatric care, but it is not clear whether and where they receive adult care treatment. • Indicator 2 – attending scheduled visits in adult care: The patient has not missed any consultations in the 3 years after transfer (yes/no), as reported in the EPR. • Indicator 3 – patient building a trusting relationship with adult provider: The patient trusts the current adult care provider as indicated by a score > 15 on a scale of 5–20 (yes/ no) in the survey. A five-item 4-point Likert scale (from 1 = “never” to 4 = “always”; α = 0.90) was used. This was measured in the questionnaire with a validated Dutch adaptation of one scale from the American Consumer Assessment of Health Plan Surveys questionnaire (Delnoij et al. 2006)

Andemariam et al., 2014 [28]

Successful transition

attendance of at least one outpatient visit at the adult SCD centre after being discharged from the paediatric SCD program

Bohun et al., 2016 [2]

Successful transfer

attending at least one adult congenital heart disease clinic visit

Vaikunth et al., 2018 [17]

Successful transfer

Transfer of care was defined as successful if patients seen in the transition clinic were subsequently seen on at least one occasion in the ACHD clinic at the adult hospital

Harbison et al., 2016 [14]

Successful transfer

The subsequent attendance at adult cardiology within 2 years of PC visit

Hazel et al., 2010 [20]

Unsuccessful transfer

failure to make initial contact with an adult rheumatologist, or failure to continue to follow-up with an adult rheumatologist 2 years after transfer (no contact for a 1 year period after the last scheduled appointment)

Wisk et al., 2015 [51]

Transfer timing

time to first visit with an adult focused PCP

Reid et al., 2004 [8]

Successful transfer

Attended at least 1 appointment of any type (e.g., clinic, echocardiogram, cardiac catheterization, or surgical) at a CACH centre. (CACH = Canadian Adult Congenital Heart)

Goossens et al., 2011 [4]

No follow-up

currently not in cardiac follow-up or if they could not be contacted by mail or phone

Wojciechowski et al., 2002 [52]

Uninterrupted care

whether or not the participant kept his or her initial ACC appointment and the length of time between the last PCC appointment and the first ACC appointment

Goossens et al., 2015 [3]

Not being in cardiac follow-up

A complete cessation of cardiac care was confirmed

Arthur et al., 2018 [29]

Continuity of primary care

Concentration of visits with a single provider or team in primary care

Hattori et al., 2016 [34]

Ended or interrupted follow-up

No transfer from paediatric care or ended or interrupted follow-up by paediatric renal services, but later presented to adult renal services without medical, social, and/or educational information prepared by paediatric renal services

Kakkar et al., 2016 [36]

Engaged in care

at least one physician visit within 6 months of the interview

Kayle et al., 2018 [37]

Continuity of care

the frequency of clinic appointments and mean duration in care in years

Stringer et al., 2015 [46]

Patient compliance with follow-up

Ongoing care with adult rheumatologic follow-up after transfer of care

Suris et al., 2015 [47]

Attending scheduled visits in adult care

Attending scheduled visits in adult care: no missed consultations unless previously cancelled and rescheduled.

Hankins et al., 2012 [33]

Fulfilment of first appointments

went for their first appointment with the adult SCD provider within 3 months of leaving paediatric care

Holmes-Walker et al., 2007 [35]

Attendance at specialist clinic

The aim was to ensure a minimum of two visits per year to the service

Kipps et al 2002 [38]

Regular clinic attendance

Regular clinic attendance rates (at least 6 monthly) from 2 years pretransfer to 2 years post-transfer

Steinbeck et al., 2015 [45]

Engagement in adult services

(i) at least one visit to an adult diabetes service post-discharge from paediatric care; (ii) frequency of visits to the adult service; and (iii) the time interval between the last paediatric diabetes service visit and first adult diabetes service visit

Van Walleghem et al., 2008 [50]

Drop out

first year fall-out rate after transfer from paediatric to adult care