Self‐efficacy did not predict the outcome of the transition to adult care in adolescents with inflammatory bowel disease

Brink, G. van den; Gaalen, Martha A C van; Zijlstra, Marieke; Ridder, Lissy de; Woude, C. Janneke van der; Escher, Johanna C.

doi:10.1111/apa.14471

Cited by 25 publications

(26 citation statements)

References 25 publications

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“…In our study, young people treated at the direct handover setting more often had a relapse in the year before transfer and were more often transferred while dealing with clinically active disease. At the TC, specific attention was given to disease activity, since it is known that having active disease at transfer can negatively influence the transition process 34. The professionals preferred to postpone the transfer until the disease was in clinical remission.…”

Section: Discussionmentioning

confidence: 99%

Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation

et al. 2020

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ObjectiveDeveloping and evaluating effective transition interventions for young people (16–25 years) with inflammatory bowel disease (IBD) is a high priority. While transition clinics (TCs) have been recommended, little is known about their operating structures and outcomes. This study aimed to gain insight into the value of a TC compared with direct handover care.DesignControlled mixed-methods evaluation of process outcomes, clinical outcomes and patient-reported outcomes.SettingTwo outpatient IBD clinics in the Netherlands.ParticipantsData collection included: semistructured interviews with professionals (n=8), observations during consultations with young people (5×4 hours), medical chart reviews of patients transferred 2 to 4 years prior to data collection (n=56 in TC group; n=54 in control group) and patient questionnaires (n=14 in TC group; n=19 in control group).OutcomesData were collected on service structures and daily routines of the TC, experienced barriers, facilitators and benefits, healthcare use, clinical outcomes, self-management outcomes and experiences and satisfaction of young people with IBD.ResultsAt the TC, multidisciplinary team meetings and alignment of care between paediatric and adult care providers were standard practice. Non-medical topics received more attention during consultations with young people at the TC. Barriers experienced by professionals were time restrictions, planning difficulties, limited involvement of adult care providers and insufficient financial coverage. Facilitators experienced were high professional motivation and a high case load. Over the year before transfer, young people at the TC had more planned consultations (p=0.015, Cohen’s d=0.47). They showed a positive trend in better transfer experiences and more satisfaction. Those in direct handover care more often experienced a relapse before transfer (p=0.003) and had more missed consultations (p=0.034, Cohen’s d=−0.43) after transfer.ConclusionA TC offer opportunities to improve transitional care, but organisational and financial barriers need to be addressed before guidelines and consensus statements in healthcare policy and daily practice can be effectively implemented.

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Section: Discussionmentioning

confidence: 99%

Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation

et al. 2020

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“…Active disease at the time of transition had been previously associated with an unsuccessful transition [15]. Accordingly, patients should complete transition to the adult center while in clinical remission or mild disease activity.…”

Section: Discussionmentioning

confidence: 99%

Transition of Inflammatory Bowel Disease Patients from Pediatric to Adult Care: An Observational Study on a Joint-Visits Approach

Corsello

Pugliese

Bracci

et al. 2020

Preprint

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BackgroundTransition from pediatric to adult care of patients affected by Inflammatory Bowel Disease (IBD) is a critical step that needs specific care and multidisciplinary involvement. The aim of our study was to evaluate the outcome of the transition process of a cohort of IBD patients, exploring their readiness and the consequent impact on quality of life.MethodsThis observational study followed transitioned patients up for a minimum of 18 months after the beginning of transition process, from January 2014 to April 2019. Transition was carried-out through joint visits pediatricians and adult gastroenterologists. Clinical data before and after transition were collected. A subgroup of patients was submitted to an anonymous online questionnaire of 38 items drawn up based on the validated questionnaires TRAQ and SIBDQ within the first 6 months from the beginning of transition process.ResultsEighty-two patients with IBD were enrolled, with a mean age at transition of 20.2±2.7 years. Before transition, 40.2% of patients already had major surgery and 64.6% started biologics. At transition, 24% of patients were in moderate to severe active phase of their disease and 40% of them had already been treated with ≥ 2 biologics. The mean value of the TRAQ questionnaires was 3.4±0.5 and the mean score of SIBDQ was 53.9±9.8. A significant association was found between a TRAQ mean score > 3 and a SIBDQ > 50 (p=0.0129). Overall, 75% of patients had a positive opinion of the transition model adopted.ConclusionsA strong association has been found between TRAQ and SIBDQ questionnaires, showing how transition readiness has a direct impact on the quality of life of the young adult with IBD.

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“…7 The optimal model for IBD transitional care and definitions of successful transition are currently unknown. 7 Self-reliance and independence of the paediatric patients are considered essential for successful transition. 8 The process generally begins after approval of the paediatric gastroenterologist and usually after obtaining the patient's consent.…”

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confidence: 99%

“…8 Successful transition was associated with effective use of medications and clinical remission at transition. 7,8 Due to significant differences between paediatric and adult IBD clinics (Table S1), the transition process itself is an important step allowing gradual adjustment according to the age and maturity of the patient. 8 Structured transition has been endorsed by both adult and paediatric international gastroenterology societies including ESPGHAN, European Crohn's and Colitis Organisation (ECCO) and NASPGHAN.…”

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confidence: 99%

“…6 The essence of the 'transition process' is the shift of responsibility of care from the parents to the patients by shifting the treatment from a paediatric care setting to adult-oriented facility, with the support of a multidisciplinary team. 7 The optimal model for IBD transitional care and definitions of successful transition are currently unknown. 7 Self-reliance and independence of the paediatric patients are considered essential for successful transition.…”

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confidence: 99%

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Knowledge of disease and self‐management of adolescents with inflammatory bowel diseases

et al. 2020

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Aim To describe factors that might affect successful transition in young adult patients with inflammatory bowel disease (IBD). Methods Questionnaires regarding the personal disease history, treatment and diseases specific knowledge and patients’ self‐efficacy were completed by teenaged patients with IBD aged 14‐18 years, during routine clinic visits. Patient answers were then compared with information obtained from the medical records and information provided by treating physician. Results The study included 80 patients with IBD, 54 (67.5%) with Crohn's disease. Patients demonstrated good knowledge in their personal disease history and current treatment. Knowledge gaps were observed in medication dosages, knowledge of potential side effects and effects of smoking on disease, with only 53/80 (66%), 12/80 (15%) and 6/36 (16.7%) of patients providing correct answers. Only 25/36 (69.4%) of the patients aged 16‐18 had read about their disease. All patients in 16‐18 age group reported needing assistance to schedule a gastroenterologist appointment. Conclusion Knowledge and self‐efficacy skills of IBD teenagers are suboptimal regarding medications, smoking and appointment management. Medical providers should work with parents and teenaged patients with IBD to allow them to attain missing information and promote self‐efficacy skills, in order to reinforce readiness towards transition.

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Self‐efficacy did not predict the outcome of the transition to adult care in adolescents with inflammatory bowel disease

Abstract: Nearly two-thirds (63%) of the adolescents who attended the IBD transition clinic had a successful transition to adult care.

Cited by 25 publications

References 25 publications

Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation

Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation

Transition of Inflammatory Bowel Disease Patients from Pediatric to Adult Care: An Observational Study on a Joint-Visits Approach

Knowledge of disease and self‐management of adolescents with inflammatory bowel diseases

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