Pediatr Gastroenterol Hepatol Nutr.  2019 Jan;22(1):28-40. 10.5223/pghn.2019.22.1.28.

Successful Transition from Pediatric to Adult Care in Inflammatory Bowel Disease: What is the Key?

• Kim J
• Ye BD

• KMID: 2430913
• DOI: http://doi.org/10.5223/pghn.2019.22.1.28

Abstract

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

Keyword

Transition; Inflammatory bowel disease; Crohn disease; Ulcerative colitis

MeSH Terms

Adult
Colitis, Ulcerative
Continuity of Patient Care
Cooperative Behavior
Crohn Disease
Delivery of Health Care
Humans
Incidence
Inflammatory Bowel Diseases*
Self Care
Transition to Adult Care*

Figure

• 

  Fig. 1 Checklists of transition readiness according to chronological age. Checklist of tasks for the patient and the medical team based on chronological age. GI: gastrointestinal, IBD: inflammatory bowel disease. Adapted from Hait E, et al. Inflamm Bowel Dis 2006;12:70-73, with permission from Oxford University Press [63].

• 

  Fig. 2 What to consider and monitor in different stages of pediatric patients undergoing transition. A summary of the different stages of adolescents and young people (AYP) with inflammatory bowel disease (IBD) transition that highlights elements that must be monitored during this process from the perspective of pediatric to adult healthcare services. MDT: multidisciplinary team. Adapted from Brooks AJ, et al. Frontline Gastroenterol 2018;9:37-44, with permission from BMJ Publishing Group Ltd. [82].

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