Transition clinic attendance is associated with improved beliefs and attitudes toward medicine in patients with inflammatory bowel disease

Abstract

AIMTo evaluated the differences in knowledge, adherence, attitudes, and beliefs about medicine in adolescents with inflammatory bowel disease (IBD) attending transition clinics.METHODSWe prospectively enrolled patients from July 2012 to June 2013. All adolescents who attended a tertiary-centre-based dedicated IBD transition clinic were invited to participate. Adolescent controls were recruited from university-affiliated gastroenterology offices. Participants completed questionnaires about their disease and reported adherence to prescribed therapy. Beliefs in Medicine Questionnaire was used to evaluate patients’ attitudes and beliefs. Beliefs of medication overuse, harm, necessity and concerns were rated on a Likert scale. Based on necessity and concern ratings, attitudes were then characterized as accepting, ambivalent, skeptical and indifferent.RESULTSOne hundred and twelve adolescents were included and 59 attended transition clinics. Self-reported adherence rates were poor, with only 67.4% and 56.8% of patients on any IBD medication were adherent in the transition and control groups, respectively. Adolescents in the transition cohort held significantly stronger beliefs that medications were necessary (P = 0.0035). Approximately 20% of adolescents in both cohorts had accepting attitudes toward their prescribed medicine. However, compared to the control group, adolescents in the transition cohort were less skeptical of (6.8% vs 20.8%) and more ambivalent (61% vs 34%) (OR = 0.15; 95%CI: 0.03-0.75; P = 0.02) to treatment.CONCLUSIONAttendance at dedicated transition clinics was associated with differences in attitudes in adolescents with IBD.

Successful transition from pediatric to adult care in inflammatory bowel disease: what is the key?

“…In a prospective study conducted in Canada, pediatric patients attending a transition clinic had stronger beliefs regarding the necessity for IBD drugs ( P =0.004), were less skeptical (7% vs. 21%, P =0.03), and were more ambivalent (61% vs. 34%, P =0.004) in terms of their attitudes toward medicine than a control group, although self-reported adherence was not statistically different compared with controls [92]. In a retrospective study conducted in the United Kingdom, patients who experienced a transition program showed a higher percentage of medication adherence (89% vs. 46%, P =0.002), a lower surgical rate (25% vs. 46%, P =0.01) or hospitalization rate (29% vs. 61%, P =0.002) within 2 years of transfer, and a lower rate of nonattendance at the clinic (29% vs. 78%, P =0.001) than those who did not [93].…”

Effect of joint transition visits on quality of life in adolescents with inflammatory bowel diseases: a protocol for a prospective, randomised, multicentre, controlled trial (TRANS-IBD)

“…7 Joint visits were the most frequently applied interventions, which were held under different circumstances and were organised by multidisciplinary groups of different compositions all around the world. [8][9][10][11][12] Non-randomised studies with low sample sizes and selection bias showed that joint visits may improve quality of life, medical adherence, patients' satisfaction and able to optimise medical visit attendance rates. 8 13-17 However, patient education programmes and the coordinating role of IBD nurses are also considered to be beneficial in structured transition interventions.…”

Adherence to Medication During Transition to Adult Services

“…However, given the small sample sizes and retrospective methods of many of these studies, more research is needed to affirm their effectiveness. In addition, literature on integrating transitional strategies into standard care, particularly in IBD, appears to also be promising, but-to date-these studies have not included objective outcomes such as adherence [46,47].…”