The research, led by Luna Antonino of the University of Antwerp together with colleagues at Ghent University and KU Leuven, set out to answer a deceptively simple question: what do general practitioners actually think about transitional care for adolescents and young adults with asthma? Transitional care, in the clinical sense, refers to the purposeful, planned movement of patients from child-centered to adult-oriented healthcare services. For conditions such as type 1 diabetes, obesity, and asthma, all of which commonly begin in childhood, this transition is recognized as a critical juncture. When it goes badly, patients may disengage from care altogether, lose access to effective inhaled therapies, and experience preventable exacerbations that erode lung function and quality of life. Yet while pediatric pulmonologists and adolescent medicine specialists have long debated how to structure the transfer, the perspective of the general practitioner has remained largely unmapped territory.

To fill that gap, the team used purposive sampling to recruit nine general practitioners and three general practitioner trainees from a variety of primary care settings. Each participant took part in an individual, semi-structured interview, a qualitative method that allows researchers to probe beyond yes-or-no answers and explore the reasoning, frustrations, and contradictions embedded in clinicians’ lived experience. The interviews were then subjected to thematic analysis, a rigorous process in which researchers code the transcript data, cluster related codes into subthemes, and distill overarching themes that capture patterns across the entire dataset. The study was conducted as part of the COCCOS project, a broader Belgian initiative aiming to build a transition program for young people with common chronic childhood-onset conditions using experience-based co-design, meaning that patients, parents, and healthcare providers all help shape the final intervention. The work received ethical approval from Antwerp University Hospital and Ghent University Hospital, and participant data were pseudonymized in line with GDPR requirements.

The most striking finding to emerge from the analysis is ambivalence. When asked to describe their role in transitional care, the general practitioners did not offer a unified picture. Some saw themselves as central coordinators who should actively guide young patients through the handover; others described a more passive position, waiting to be informed after the specialist had already arranged the transfer. This inconsistency extended to their experiences: some clinicians reported smooth, well-communicated transitions, while others described patients arriving in adult care with little warning, incomplete information, or no clear plan. The researchers interpret this ambivalence as a symptom of a deeper problem, namely the absence of a clearly defined role for primary care within the transition process. Without an agreed-upon job description, each general practitioner improvises, and the quality of the transition depends less on the system than on the individual clinician’s initiative and luck.

That improvisation has technical consequences. Asthma management in adolescents and young adults is not simply a matter of refilling prescriptions. It requires ongoing assessment of inhaler technique, vigilance for the loss of adherence that commonly accompanies adolescence, monitoring of lung function, attention to comorbidities such as allergic rhinitis and obesity, and shared decision-making about controller therapy. A general practitioner who receives a patient without a structured summary of the pediatric history, previous exacerbation patterns, lung function trends, and the medication regimen the patient was actually following, as opposed to the one recorded in the chart, starts at a significant disadvantage. The study’s findings on interprofessional communication speak directly to this problem. Participants described communication with pediatric and adult specialists as insufficient, with information transfer often occurring late, incompletely, or not at all. In a well-functioning transitional care model, the primary care physician would be looped in well before the transfer date, briefed on the plan, and invited to contribute the longitudinal perspective that only continuous, community-based care can provide.

Coordination emerged as a second major theme. The general practitioners recognized that good transitional care is inherently interprofessional, involving pediatricians, pulmonologists, nurses, pharmacists, and the primary care team. But they reported that the coordination of these actors is frequently left to chance. Nobody, in their account, clearly owns the transition. Pediatric services may assume the adult side will pick up the thread; adult services may assume the patient will present with complete documentation; and the patient, often a teenager juggling school, work, and a developing sense of independence, may simply fall through the gap. The general practitioners expressed a willingness to take on a coordinating role, yet they simultaneously doubted whether they had the mandate, the information, and the support to do so effectively. This tension between willingness and capacity is precisely the kind of finding that experience-based co-design projects like COCCOS are intended to surface before a new transition program is built.

Patient involvement formed a third thread in the analysis. The clinicians acknowledged that adolescents and young adults need to be gradually prepared to manage their own condition, a process that includes learning to recognize worsening symptoms, understanding the purpose of maintenance therapy versus reliever therapy, and taking ownership of appointments and prescriptions. Yet the interviews revealed uncertainty about how to foster this self-management within the limited time of a standard primary care consultation, and about how to engage parents appropriately, keeping them supportive without allowing them to dominate a young adult who should increasingly speak for himself or herself. Guidance, the fourth theme, captured the general practitioners’ desire for practical tools: structured protocols, checklists, and clear pathways that would tell them when to start preparing a patient for transition, what information to request, and how to follow up after the transfer. The absence of such guidance, combined with gaps in professional training on adolescent transition, left many feeling that they were expected to perform a task they had never been formally taught.

The clinical stakes of these gaps are not trivial. Poorly managed transitions are associated with disengagement from care, missed follow-up, disease exacerbation, and avoidable emergency department visits among young people with chronic conditions. Asthma is one of the most common chronic diseases of adolescence, and the transition years coincide with peak risk of adherence decline. A young adult who loses continuity of care during this window may accumulate years of suboptimal control before re-engaging with the health system, sometimes only after a severe exacerbation. The study’s authors argue that general practitioners, by virtue of their long-term relationships with patients and families and their position at the center of the Belgian primary care system, could play a pivotal role in preventing exactly this scenario, but only if the structural barriers identified in the research are addressed.

What would addressing those barriers look like in practice? The findings point toward several concrete directions. First, role clarity: transition programs should explicitly define what is expected of the general practitioner, the specialist, and the patient at each stage of the handover, so that responsibility is shared by design rather than by accident. Second, communication infrastructure: structured information transfer, ideally with a standardized summary of the pediatric asthma history reaching primary care before the first adult appointment, would give general practitioners the data they need to manage the patient competently from day one. Third, training: both practicing general practitioners and trainees need education in adolescent medicine and transition-specific skills, from assessing readiness for self-management to conducting consultations that respect a young person’s growing autonomy. Fourth, patient-centered design: any transition pathway should be co-created with adolescents and young adults themselves, reflecting the co-design methodology at the heart of the COCCOS project, so that the process fits the realities of young lives rather than the convenience of institutions.

The study has limitations inherent to its design. It captures the perspectives of twelve clinicians in a single country’s healthcare system, and qualitative interview studies describe experiences and perceptions rather than measuring outcomes. The general practitioners who agreed to be interviewed may also be more engaged with the topic than their peers. Nevertheless, the consistency of the themes, ambivalence about roles, weak interprofessional communication, insufficient coordination, uncertain patient involvement, and a hunger for guidance and training, provides a clear evidence base for the transition program the COCCOS project aims to develop, and a caution for health systems elsewhere. As more young people with childhood-onset chronic conditions survive and thrive into adulthood, the moment when their care changes hands will only grow in importance. This study makes the case that the general practitioner’s office, often the first and most enduring point of contact in adult healthcare, must no longer be an afterthought in that moment, but a planned, supported, and fully informed anchor of the transition itself.

Subject of Research: General practitioners' perspectives on transitional care from pediatric to adult services for adolescents and young adults with asthma

Article Title: General practitioners’ perspectives on transitional care for adolescents and young adults with asthma: a qualitative study

Article References: Antonino, L., Van Hoorenbeeck, K., van Olmen, J., Janssens, N., Van Wilder, L., Van Hecke, A., Wyngaert, K. V., De Smedt, D., Verhulst, S., & Goossens, E. (2026). General practitioners’ perspectives on transitional care for adolescents and young adults with asthma: a qualitative study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15789-0

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15789-0

Keywords: transitional care, asthma, general practitioners, primary care, adolescents, young adults, pediatric-to-adult transition, continuity of care, interprofessional communication, qualitative research, health services research, chronic conditions