Chronic illness and transition: time for action.

Adolescence is a developmental stage involving complex biopsycho-social changes that both impact upon and are impacted by chronic illness. There are increasing numbers of young people with chronic illnesses and/or disabilities surviving into adulthood; however, there has been limited preparation for the management of this group of young people. Despite poorly planned transition resulting in poor outcomes in physical and mental health, social and educational domains for many transitional policies remain as policies with adolescent health practitioners "talking the talk" but failing to "walk the walk". At the time of writing, only a minority of services have implemented transition policies identified as essential and recommended by young people, families, multidisciplinary teams, and target adult services. Lack of training in adolescent development and health care has been reported as a major barrier to the implementation of effective transitional programs. There needs to be a paradigm shift that acknowledges that after over 20 years of agreeing what is needed there is no further need to wait for evidence from rigorous evaluations to institute programs that ensure that adolescents are adequately trained in disease self-management and that a plan is in place to ensure their disease control or quality of life does not suffer in the move from pediatrics to adult services.