Table 2.

Example of successful steps in transition of patients with PWS.

Visit	Clinic setting	Actions
1	Paediatric	• Paediatrician assesses adult height and patient undergoes multidisciplinary evaluation (i.e., rheumatologist, cardiologist, psychologist, etc.) • Adult endocrinologist receives oral summary of the patient’s medical history and detailed description of the present situation (including medical examination, socio-educational aspects of the situation, psychological and relational issues, medical therapies, family structure, etc.) • Patients are given opportunity to talk with physicians alone, without parents, to voice concerns about sexual and reproductive issues, psychological difficulties, and autonomy in everyday life
2	Paediatric	• Can comprise multiple visits • Visits occur every 6 months and include complete medical check-up • Through joint decision by physicians, patient, and their family, date is set for first visit in adult endocrinology unit; could be as soon as 6 months or up to 2 years later, depending on complexity of the situation and patient’s readiness for transition • Whenever patient is ready for first ‘adult’ visit, paediatrician sends complete medical report to adult clinic and sets appointment
3	Adult	• Evaluation performed during last transition visit is similar to the other check-ups undertaken in paediatric unit; primary difference is environmental: s/he is now considered an adult and begins management under care of adult specialists