P259 Systematic review of prognostic factors affecting the acquisition of transition readiness skills in patients with inflammatory bowel disease

Abstract Background Around 25% of patients with inflammatory bowel disease (IBD) are diagnosed before the age of 20, meaning transition from paediatric to adult healthcare is inevitable for some. Good transition is important to maintain quality of care, and poor transition can result in adverse outcomes such as clinic and medication non-adherence. Certain skills are required in order for someone to be ready to transition, and the aim of this study was to identify modifiable and non-modifiable factors affecting the development of these skills in young people with IBD. Methods This review was registered on the PROSERO database (CRD42019152272) and conducted in line with PRISMA guidelines. Studies were included if they (1) explored factors affecting the acquisition of transition readiness skills in IBD patients 2) were written in English (3) were published since 1999. The databases MEDLINE, CINAHL and PsychINFO were searched from September - October 2019. Bias was assessed using the Quality in Prognostic Studies tool. Results Searches identified 822 papers and 27 full texts were retrieved. Sixteen papers were included in the final review, reporting on 1770 patients ranging from 10–29 years of age. Fourteen studies were cross-sectional and two longitudinal. Six assessed transition readiness, five self-management, two disease knowledge, one medication knowledge, one health literacy, and one both disease knowledge and self-management. Modifiable factors found were increased provider-communication about transition, transition duration, and health care satisfaction. Participant self-efficacy was found to be significant for three studies, and increased parent autonomy granting was related to higher disease knowledge in one study. Non-modifiable factors identified were age, sex, socioeconomic score, participant educational level and ethnicity. Nine studies showed increased age as a positive prognostic factor, and two additional papers found an effect for certain domains assessed. Four studies showed higher scores for females, and one study demonstrated higher self-rated self-efficacy scores for males. Disease-related non-modifiable factors identified were IBD family history, age at diagnosis, and absence from school. Conclusion This study identified five potentially modifiable factors. Strategies or interventions to address these in the IBD population transitioning to adult care might lead to improved experience and outcomes. This review also identified eight non-modifiable factors. This may allow healthcare and allied professionals to identify those at an increased risk of not developing the necessary competencies for transition and adapting the way in which they approach transition for each individual.

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Systematic review of factors affecting transition readiness skills in patients with inflammatory bowel disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa245 ◽

2020 ◽

Author(s):

Lara E Johnson ◽

Matthew J Lee ◽

Tamara Turner-Moore ◽

Lydia R Grinsted Tate ◽

Alenka J Brooks ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Self Efficacy ◽

Self Management ◽

Factors Affecting ◽

Disease Knowledge ◽

Transition Readiness ◽

Modifiable Factors ◽

Inflammatory Bowel ◽

Readiness Skills

Abstract Background and Aims The incidence of inflammatory bowel disease (IBD) diagnosed before adulthood is increasing worldwide. Transition from paediatric to adult healthcare requires certain skills. The aim of this study was to identify factors affecting these skills. Methods This review was registered on the PROSPERO database (CRD42019152272). Inclusion criteria: 1) studies of factors affecting transition readiness skills in patients with IBD 2) written in English 3) published since 1999. MEDLINE, CINAHL and PsychINFO databases were searched between 1999-2019. Quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results Searches identified 822 papers. Sixteen papers were included. Age was positively associated with skills including disease knowledge and performing self-management behaviours (14 studies). Improvement often occurs at 18, however, skill deficiency may still remain. Increased self-efficacy (confidence) was associated with greater disease knowledge and performing self-management behaviours (3 studies). Self-efficacy was positively correlated with transition duration (2 studies) and health-related quality of life (r=0.57, p<0.001) (1 study), negatively correlated with depression (r=-0.57, p<0.001) and anxiety (r=-0.23, p=0.03) (1 study), and associated with higher education level (2 studies) and a family history of IBD (1 study). Females had higher self-management scores (3 studies), and greater healthcare satisfaction was significantly associated with higher knowledge (1 study). Greater transition communication improved knowledge, self-management, and overall transition readiness (2 studies). Conclusions Potentially modifiable factors have been identified that could be supported in the transitioning IBD population to improve transition readiness. Identification of those with non-modifiable characteristics associated with poor readiness may aid targeted support.

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The Role of Patient Self-efficacy in Inflammatory Bowel Disease Self-management

The American Journal of Gastroenterology ◽

10.14309/00000434-201310001-01768 ◽

2013 ◽

Vol 108 ◽

pp. S533

Author(s):

Benjamin Bensadon ◽

Hanumantha Ancha ◽

Lindsay Boeckman ◽

Amber Crosby ◽

Tauseef Ali

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Self Efficacy ◽

Self Management ◽

Inflammatory Bowel

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Provider Awareness Alone Does Not Improve Transition Readiness Skills in Adolescent Patients With Inflammatory Bowel Disease

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/mpg.0000000000000405 ◽

2014 ◽

Vol 59 (2) ◽

pp. 221-224 ◽

Cited By ~ 17

Author(s):

Laurie N. Fishman ◽

Sonja I. Ziniel ◽

Max E. Adrichem ◽

Susan M. Fernandes ◽

Janis Arnold

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Transition Readiness ◽

Adolescent Patients ◽

Inflammatory Bowel ◽

Readiness Skills

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“ADULTING” WITH IBD: A NOVEL, VIRTUAL INFLAMMATORY BOWEL DISEASE TRANSITION PROGRAM FOR TEENS AND CAREGIVERS

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.124 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S52-S52

Author(s):

Jacklyn Stellway ◽

Malika Waschmann ◽

Henry Lin ◽

Michael Harris

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Self Efficacy ◽

Program Effectiveness ◽

Assessment Tools ◽

Pediatric Care ◽

Adult Care ◽

Transition Readiness ◽

Successful Transition ◽

Inflammatory Bowel

Abstract Introduction: Rates of newly diagnosed inflammatory bowel disease (IBD) in pediatric patients increased by 133% from 2007–2016. With the rise comes an increase in patients ultimately transitioning from pediatric to adult GI care. While pediatric care is family-centered and multi-disciplinary adult care is patient-centered with expectation for autonomy. However, less than 15% of patients are fully responsible for their IBD care by late adolescents. The transition period is marked by adverse health outcomes including decreased compliance and increased disease activity and hospitalization. Our data recognized up to 74% of IBD youth reported not having discussed transition at home or with their GI providers, and a desire to receive information in person. Without guidance from the GI team patients may not have adequate time to plan for successful transition. Methods: A one-day 3.5-hour transition preparedness workshop was developed to address the demonstrated need in a pediatric GI clinic. Recruitment letters were distributed to 134 IBD youth ages 15–19. Eighteen consenting participants completed measures prior to and following the workshop (at 3 and 12 months). Assessment tools included previously validated self- and parent-reports: Patient Health Questionnaire-8, General Anxiety Disorder-7), Transition Readiness Assessment Questionnaire, IBD Self Efficacy Scale; and Helping for Health Inventory. Results: While the workshop was designed for in person the pandemic required shift to virtual had strengths and potential drawbacks. Youth across 300 miles were able to attend, as well as IBD young adult peers sharing their personal transition experiences. It is hypothesized pre-workshop data will demonstrate low levels of transition readiness and IBD self-efficacy, with increases in 3- and 12-month post-workshop data. Transition readiness is also presumed to correlate with measures of IBD self-efficacy and miscarried helping by parents. We will present program effectiveness data with factors known to both facilitate and obstruct successful transition from pediatric to adult IBD care. Conclusion: There remains a paucity of literature evaluating the efficacy of IBD transition programs. This research informs such programs by evaluating the efficacy of a one-day virtual workshop on skill development and knowledge. Assessment data and follow up after transition to adult care will provide important information to guide development of evidence-based transition planning for IBD patients.

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Transition Readiness Skills Acquisition in Adolescents and Young Adults with Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1097/mib.0000000000000352 ◽

2015 ◽

Vol 21 (5) ◽

pp. 1125-1131 ◽

Cited By ~ 45

Author(s):

Wendy N. Gray ◽

Erin Holbrook ◽

Pamela J. Morgan ◽

Shehzad A. Saeed ◽

Lee A. Denson ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Young Adults ◽

Bowel Disease ◽

Adolescents And Young Adults ◽

Skills Acquisition ◽

Transition Readiness ◽

Inflammatory Bowel ◽

Readiness Skills

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Developing an Online Program for Self-Management of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Patients’ Needs and Wants

Digestive Diseases and Sciences ◽

10.1007/s10620-021-07109-9 ◽

2021 ◽

Author(s):

Sophie Fawson ◽

Lesley Dibley ◽

Kaylee Smith ◽

Joanna Batista ◽

Micol Artom ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Self Management ◽

Online Program ◽

Inflammatory Bowel

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Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000581 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000581

Author(s):

Madiha Cheema ◽

Nikola Mitrev ◽

Leanne Hall ◽

Maria Tiongson ◽

Golo Ahlenstiel ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Severe Depression ◽

Chronic Illnesses ◽

Electronic Survey ◽

Validated Questionnaire ◽

Younger Age ◽

Modifiable Factors ◽

High Prevalence ◽

Inflammatory Bowel

BackgroundThe global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic.MethodsAn electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected.Results352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression.ConclusionHigh prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.

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