Transition care in inflammatory bowel disease: A needs assessment survey of Quebec gastroenterologists and allied nurses

AIM To determine the tools needed and problems encountered during the transition of inflammatory bowel disease (IBD) patients from pediatric to adult gastroenterologists (GIs) in Québec, Canada. METHODS We conducted a needs assessment survey of Quebec health care professionals (HCPs). The survey was handed out to 136 Québec HCPs at a local conference in 2013. Additionally, it was emailed to any other HCPs in Quebec involved in caring for IBD patients. The completed surveys were compiled to derive descriptive data. Further specific subgroup analysis was then conducted. RESULTS Among the conference attendees and individuals emailed 77 (28.2%) completed the questionnaire. Respondents included adult GIs (61.3%), pediatric GIs (20.8%) and IBD nurses (18.3%). The majority of respondents believed that a standardized structure is important for a successful transition. Adult and pediatric GIs equally felt that patients were inadequately prepared for the transition (P = 0.6). There were significant differences between adult and pediatric GIs when it came to resource availability (55.6% vs 90.9%, P = 0.002) and perceived need of a formal transition clinic (21.7% vs 68.8%, P = 0.0006). Both transition program and medical summaries were identified as the most valuable tools to improve transition. CONCLUSION As described in previous studies, our survey reinforces the importance of a transition program, education for young adult IBD patients and the need to improve communication between adult and pediatric GIs.

[1]  J. Andrews,et al.  Perspectives of paediatric and adult gastroenterologists on transfer and transition care of adolescents with inflammatory bowel disease , 2014, Internal medicine journal.

[2]  J. Hyams,et al.  Transition of management in adolescents with IBD , 2014, Nature Reviews Gastroenterology &Hepatology.

[3]  R. Russell,et al.  The requirements and barriers to successful transition of adolescents with inflammatory bowel disease: differing perceptions from a survey of adult and paediatric gastroenterologists. , 2012, Journal of Crohn's & colitis.

[4]  J. B. Layton,et al.  A Clinical Tool to Measure the Components of Health-Care Transition from Pediatric Care to Adult Care: The UNC TRxANSITION Scale , 2012, Renal failure.

[5]  Subrata Ghosh,et al.  Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. , 2012, Gastroenterology.

[6]  L. Fishman,et al.  Medication Knowledge: An Initial Step in Self-management for Youth With Inflammatory Bowel Disease , 2011, Journal of pediatric gastroenterology and nutrition.

[7]  E. Benchimol,et al.  Assessment of knowledge in adolescents with inflammatory bowel disease using a novel transition tool , 2011, Inflammatory bowel diseases.

[8]  A. Griffiths,et al.  Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends , 2011, Inflammatory bowel diseases.

[9]  L. Fishman,et al.  Self-Management of Older Adolescents with Inflammatory Bowel Disease: A Pilot Study of Behavior and Knowledge as Prelude to Transition , 2010, Clinical pediatrics.

[10]  R. Baldassano,et al.  Barriers to oral medication adherence for adolescents with inflammatory bowel disease. , 2010, Journal of pediatric psychology.

[11]  J. Lindsay,et al.  Inflammatory bowel disease in young people: The case for transitional clinics , 2010, Inflammatory bowel diseases.

[12]  A. Neu,et al.  Follow-up of adolescents with diabetes after transition from paediatric to adult care: results of a 10-year prospective study. , 2010, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[13]  J. Stockman.  Transition of adolescents with inflammatory bowel disease from pediatric to adult care: a survey of adult gastroenterologists , 2010 .

[14]  F. Cadario,et al.  Transition process of patients with type 1 diabetes (T1DM) from paediatric to the adult health care service: a hospital‐based approach , 2009, Clinical endocrinology.

[15]  J. Kelsen,et al.  Inflammatory bowel disease: the difference between children and adults. , 2008, Inflammatory bowel diseases.

[16]  A. Bousvaros,et al.  Research and clinical challenges in paediatric inflammatory bowel disease. , 2008, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[17]  D. J. Holmes-Walker,et al.  A transition care programme which improves diabetes control and reduces hospital admission rates in young adults with Type 1 diabetes aged 15–25 years , 2007, Diabetic medicine : a journal of the British Diabetic Association.

[18]  Mieke Koehoorn,et al.  The Epidemiology of Inflammatory Bowel Disease in Canada: A Population-Based Study , 2006, The American Journal of Gastroenterology.

[19]  Sandra C. Kim,et al.  Inflammatory bowel diseases in pediatric and adolescent patients: clinical, therapeutic, and psychosocial considerations. , 2004, Gastroenterology.

[20]  R. Yehuda,et al.  Medication adherence in pediatric and adolescent liver transplant recipients. , 2004, Pediatrics.

[21]  A. Griffiths,et al.  Transition of the patient with inflammatory bowel disease from pediatric to adult care: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. , 2002, Journal of pediatric gastroenterology and nutrition.

[22]  D P Orr,et al.  Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. , 1993, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[23]  lhealtlhy youin-g,et al.  Hospital for Sick Children , 1857, British medical journal.