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ISO2026: Transitioning Pediatric Patients
This session addresses the planned movement of young patients with bone disease from pediatric centered care to adult centered care, using a clinical case of a young man with osteogenesis imperfecta to frame the discussion. It distinguishes transition, an intentional and gradual developmental process that begins years in advance, from transfer, the formal handoff of care between providers, and it outlines the ideal timeline for introducing transition, assessing readiness, identifying adult providers, and confirming the first adult visit. The session reviews validated readiness assessment instruments and examines why transition is uniquely challenging in rare bone disease, where adult expertise may be scarce, care is more fragmented, and the adult natural history of many conditions remains incompletely understood. It summarizes the current evidence base and major guidance documents, including the AAP, AAFP, and ACP clinical report, the Got Transition Six Core Elements, and recent European consensus and scoping review work specific to rare bone and mineral conditions, and it draws out the common themes across these sources. The session then details the categories of information that must be assembled and communicated before transfer, spanning diagnosis and genetics, skeletal phenotype, fracture and orthopedic history, bone health investigations, medication history, acute care planning, rehabilitation, dental and hearing concerns, mental health, and reproductive health. It concludes with the practical elements that reduce the risk of care disruption, including a dedicated coordinator, a structured handover, and active engagement of adult specialists.
Target Audience
This continuing education activity is intended for use by health professionals who participate in the care of patients at risk for or suffering from osteoporosis, in the areas of primary care, endocrinology, geriatrics, gynecology, internal, obstetrics, orthopedics, osteopathy, pediatrics, physiatry, radiology, rheumatology and physical therapy.
This includes physicians, nurse practitioners, registered nurses, pharmacists, physician assistants, technologists, researchers, public health professionals and health educators with an interest in osteoporosis and bone health.
Learning Objectives
Upon completion of this session, participants will be able to:
1. Distinguish transition from transfer, and describe transition as a planned, gradual developmental process that begins years before the formal handoff of care.
2. Describe the differing paradigms of pediatric and adult care, including differences in care coordination, patient autonomy, and the expectation that adults coordinate their own specialty care.
3. Apply structured readiness assessment tools, such as the Am I ON TRAC for Adult Care questionnaire and the Transition Readiness Assessment Questionnaire, to evaluate a young person's preparedness for adult care.
4. Identify the aspects of rare bone disease that must be addressed before transfer, including diagnosis and genetics, skeletal phenotype, fracture and orthopedic history, medication history, acute care planning, and reproductive health.
5. Describe the roles of the clinical coordinator, pediatric specialty provider, adult specialty provider, primary care provider, and patient or family within a structured transition process, and explain how each reduces the risk of care disruption.
Name of Individual | Individual's Role(s) in Activity | Name of Ineligible Company(s) | Nature of Relationship(s) |
| Eric Rush, MD, FAAP | Speaker | N/A | N/A |
| Amy Mitchell, MSN, FNP-C | Planner/Accredited Provider Program Director & Content Expert | Amgen & Radius Health | Speaker’s Bureau, Scientific Advisory Board, Consulting |
Ami Patel | BHOF Staff, Vice President of Science & Education | N/A | N/A |
Andrea Medeiros | BHOF Staff, Vice President of Public Health & Policy | N/A | N/A |
Disclosures:
• Research support/PI: Alexion Astrazeneca Rare Disease
• Employee: N/A
• Consultant: Alexion AstraZeneca Rare Disease, Kyowa Kirin, Regeneron, Bridge Bio
• DSMB: Alesta, Inozyme
• Major stockholder: N/A
• Speakers’ bureau: Alexion, Kyowa Kirin
• Scientific advisory board: Rare Bone Disease Alliance, Osteogenesis Imperfecta Foundation, Marfan Syndrome Foundation
Accreditation Statement
The Bone Health and Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Bone Health and Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
CME Program Eligibility
Method of Participation in the Learning Process: Clinician learners will view and analyze the subject matter, conduct additional informal research through related internet searches on the subject matter, and complete a post-test assessment of knowledge and skills gained as a result of the activity.
After participating in this activity, the reader has the option of taking an evaluation for this activity. It is estimated it will take 1.0 hour(s) to complete the reading and take the evaluation. Continuing education credit will be available for two years from the date of publication.
Disclosure of Commercial Support
It is the policy of the Bone Health & Osteoporosis Foundation (BHOF) to ensure balance, independence, objectivity, and scientific rigor in all its sponsored publications and programs. BHOF requires the disclosure of the existence of any significant financial interest or any other relationship the sponsor, Editorial Board or Guest Contributors have with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. All authors and contributors to this continuing education activity have disclosed any real or apparent interest that may have direct bearing on the subject matter of this program.
Please be advised that BHOF’s accreditation status with ACCME and ANCC does not imply endorsement by BHOF, ACCME or ANCC of any commercial products displayed in conjunction with this activity or endorsement of any point of view.
Refund Policy
BHOF offers no returns or refunds on online internet CME activities purchased through our store. All sales are final. Meeting and workshop registrations will be refunded in accordance with the cancellation policy of the meeting and/or workshop, as outlined at registration.
Available Credit
- 1.00 AMA PRA Category 1 Credit™The National Osteoporosis Foundation is an approved Accreditation Council for Continuing Medical Education (ACCME) accredited CME provider through March 2023. ACCME accreditation accelerates learning, change and improvement in the field of osteoporosis. The National Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The National Osteoporosis Foundation designates educational activities for AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 ANCCThe mission of the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is to promote excellence in nursing and health care globally through credentialing programs. The National Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The National Osteoporosis Foundation designates educational activities for continuing nursing education credit(s).
- 1.00 Participation
- 1.00 Participation/AttendanceA certificate of attendance will be provided to all other attending healthcare professionals. Nurse practitioners and physician assistants may request AMA PRA Category 1 Credit(s)™ certificate of participation. Please refer to your provider to determine whether this program will qualify for other categories of continuing education credits. The American Academy of Physician Assistants (AAPA) also accepts educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the Accreditation Council for Continuing Education (ACCME).