Biopsychosocial factors related to transition among adolescents and young adults with sickle cell disease: A systematic review

Crit Rev Oncol Hematol. 2021 Nov:167:103498. doi: 10.1016/j.critrevonc.2021.103498. Epub 2021 Oct 14.


It is critical to support adolescents and young adults (AYAs) with sickle cell disease (SCD) during transition to adult healthcare. We provide a systematic review of literature related to biopsychosocial influences on transition among AYAs with SCD. Data sources included studies published between January 2010 and May 2020. Forty-four studies were included. Biopsychosocial factors related to improved transition outcomes included older AYA age, greater disease severity, intact neurocognitive functioning, and greater pain coping skills. Financial and insurance barriers were noted. The importance of cultural considerations and provider communication were noted across two qualitative studies. Ten studies assessed efficacy of transition interventions, with 80 % resulting in improvements; however, retention in programs was low and gaps in knowledge and skills remained. Incorporation of early, ongoing assessments of transition readiness and barriers into culturally-tailored interventions aimed at improving transition outcomes is recommended. Examination of longitudinal relationships and interactions across biopsychosocial influences is needed.

Keywords: Biopsychosocial; Sickle cell disease; Systematic review; Transition.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell* / epidemiology
  • Anemia, Sickle Cell* / therapy
  • Humans
  • Severity of Illness Index
  • Transition to Adult Care*
  • Young Adult