Instruments to Assess Transition Readiness Among Adolescents With Chronic Disease: A COSMIN Systematic Review of Measurement Properties

BackgroundTransition readiness is a key predictor of the success of the medical transition. There are numerous categories of assessment instruments for transition readiness in adolescents with chronic disease, but systematic integration and standardized evaluation of instruments are limited regarding measurement properties, complicating the selection of scientifically valid and reasonable instruments. This review aimed to critically appraise, compare, and summarize the transition readiness assessment instruments in adolescents with chronic diseases.MethodsA comprehensive search was conducted in 10 databases from their inception to September 3, 2023. The Consensus-based Standards for Selection of Health Measurement Instruments (COSMIN) systematic review guideline was used to evaluate the quality of the Patient-Reported Outcome Measures (PROMs) and to facilitate the recommendation of the most suitable measuring instruments.ResultsThe total number of retrieved articles was 1798, out of which 74 were selected for full-text evaluation. Finally, a total of 41 articles were included, involving 22 transition readiness assessment instruments. Nine of the assessment instruments were generalized assessment instruments, whereas 13 were for specific chronic diseases. Because of insufficient or uncertain content validity and moderate or low quality of evidence, the 22 assessment instruments were recommended by grade B.ConclusionsThis systematic review offers a comprehensive overview of the measurement characteristics of the transition readiness assessment instrument for adolescent patients with chronic illnesses, along with corresponding recommendations. The findings indicate that no instrument demonstrated superior performance over others. Consequently, future efforts should focus on developing additional high-quality instruments in accordance with COSMIN guidelines to evaluate transition readiness among this population precisely.