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

Abstract

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.

Trajectories of the Transition Readiness Assessment Questionnaire Among Youth With Inflammatory Bowel Disease

“…For research purposes, this study provides important data to inform how researchers decide what an adequate TRAQ-20 score is for declaring a patient as having adequate transition readiness. Previous studies have used expert-determined benchmarks for identifying adequate transition readiness 19,27. The centile scores lay out clear patterns for TRAQ-20 scores across this age range, informing future target-setting and benchmarking.…”

“…Previous studies have used expertdetermined benchmarks for identifying adequate transition readiness. 19,27 The centile scores lay out clear patterns for TRAQ-20 scores across this age range, informing future target-setting and benchmarking. They also help researchers consider age and gender, known factors associated with transition readiness when setting TRAQ-20 targets and goals.…”

Impact of a new young adult inflammatory bowel disease transition clinic on patient satisfaction and clinical outcomes

“…Further, due to limitations in the number of patients available for recruitment in both the YAC and AC, controls could not be matched based on disease activity. For future research, we would suggest that other factors known to impact transition including transition readiness, as identified by Corsello et al 5 should be explored, as well as adherence to medication therapy. We would suggest that strategies to reduce clinic wait times and increase clinician consistency be adopted.…”

“…There is limited Australian literature exploring outcomes regarding patient satisfaction and clinical benefits in relation to young adult IBD transitional clinics, whilst international literature has demonstrated these benefits. 5,6 The ED still remains one of the most common points of interaction between IBD patients and the health-care system. 7 Therefore, we conducted a 4-year review of patients attending our YAC to investigate two objectives.…”