Planned Transition of Adolescent Patients with Inflammatory Bowel Disease Results in Higher Remission Rates

J Pediatr Nurs. 2019 Mar-Apr:45:62-66. doi: 10.1016/j.pedn.2019.02.003. Epub 2019 Feb 10.

Abstract

Purpose: To evaluate the effect of our current transition process on clinical outcomes in adolescent patients with inflammatory bowel diseases (IBD).

Design and methods: Two groups of patients with IBD diagnosed in pediatric care were compared retrospectively: Group A patients did not attend the transition process, while Group B patients entered the planned transition service. Outcomes at 1-year after transfer to adult care were evaluated.

Results: Forty-five patients with IBD diagnosed under the age of 18 years were identified of whom 35 had Crohn's disease and 10 had ulcerative colitis. Twenty-four patients were in Group A (without transition), and 21 patients in Group B (with at least one planned transition visit). Mean age at diagnosis was 15.1 ± 2.2 and 13.7 ± 3.0 years (p = 0.086), respectively. There were no significant differences in disease duration before transfer, Montreal classification at diagnosis, body mass index, anti-TNF therapy usage, and disease status at transfer between the two groups. A significantly higher number of Group B patients were in remission at 12 months after transfer when compared to patients in Group A (11 vs. 18, respectively, p = 0.037). There was a significant difference between groups regarding the number of scheduled visits within the examined period (9 vs. 16, p = 0.011, respectively).

Conclusions: Planned transition visits resulted in higher disease remission rate at 1-year follow-up after transfer from pediatric to adult health care system in adolescent patients with IBD.

Practice implication: Well-established transition programs in IBD are needed.

Keywords: Adolescent health; Inflammatory bowel diseases; Remission; Transfer; Transitional care.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adolescent Health Services / standards*
  • Adult
  • Colitis, Ulcerative / psychology
  • Colitis, Ulcerative / therapy*
  • Crohn Disease / psychology
  • Crohn Disease / therapy*
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Transition to Adult Care / standards*
  • Transitional Care / standards*
  • Young Adult

Supplementary concepts

  • Pediatric Crohn's disease
  • Pediatric ulcerative colitis