Supplementary Material for: Transition of care for adolescents and young adults living with obesity: a systematic review with indirect evidence from conditions deemed being transferable

Introduction: Adolescence and early adulthood represent a critical phase for management of chronic diseases, including obesity. To improve transition of care in adolescents and young adults with obesity (AYALwO), the main goal was to summarize the current evidence on transition of care interventions (T-interventions) for obesity management. Anticipating a lack of evidence on T-interventions for AYALwO, we expanded the patient population to include individuals with other chronic diseases that can be appropriately transferred, such as diabetes.
Methods: We searched three databases and one trial registry from 01/2013-07/2025 onwards and screened reference lists of included trials, i.e. randomized-controlled trials (RCTs) and non-randomized-controlled studies of interventions (NRSI) enrolling AYALwO, type 1 (T1D)/ 2 diabetes and RCTs only for inflammatory bowel disease (IBD), arthritis or asthma (effects for these populations were considered transferable in case of lack of trials in AYALwO). We evaluated outcomes of T-interventions, e.g. HbA1c, quality of life, self-management or transition readiness. The review process was completed by two reviewers, independently. Results were summarized via random-effects meta-analysis or descriptively.
Results: We included 14 RCTs (n=9 T1D, n=2 mixed population, n=1 IBD, n=1 arthritis, n=1 asthma) and four NRSI (n=2 T1D, n=2 mixed population). Prespecified outcomes were mostly reported infrequently and/or heterogeneously. Effect measures were mostly inconclusive or not meaningful. No effect was shown for HbA1c in seven RCTs (mean difference 0.12% [95%-confidence interval -0.59; 0.83]) or in two NRSI. A higher transfer rate by appointment reminders (one RCT) or consultation at the same physician for pediatric and adult care (one RCT) and an improvement of transition readiness for transition-oriented patient education programs (one RCT, one NSRI) was found. Certainty of evidence (CoE) was very low for all outcomes, mainly due to a high risk of bias, indirectness and imprecision.
Conclusion: We found no trial for AYALwO. Evidence on other chronic diseases was limited, showing that T-interventions lead to improvements in transfer rate or transition readiness (very low CoE). This highlights the need for future research regarding T-interventions in AYALwO.
PROSPERO-ID: CRD42024513411