P008 EVALUTING THE EFFECTIVENESS OF TRANSITION OF CARE FOR PEDIATRIC INFLAMMATORY BOWEL DISEASE PATIENTS USING A STANDARDIZED TRANSITION PROCESS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S48-S49
Author(s):  
Jennifer Shearer ◽  
Sharon Perry ◽  
Nicole Lidyard ◽  
Kimberly Burkhart ◽  
Jeffry Katz ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Retrospective Chart Review ◽  
Inactive Disease ◽  
Adult Care ◽  
Health Maintenance ◽  
Positive Screen ◽  
Transition Readiness ◽  
Inflammatory Bowel ◽  
Pediatric Ibd

Abstract Significance The incidence of inflammatory bowel disease (IBD) is rising around the globe. As pediatric IBD patients approach adulthood, they are in jeopardy of a lapse in care. We developed a standardized a health maintenance transition visit (HMV) to supplement standard medical care visits (SMV) to prepare patients for transition. Our aim was to assess the effectiveness of the structured HMV using the Transition Readiness Assessment Questionnaire (TRAQ) to predict readiness at time of transfer to an adult gastroenterologist. Methods A retrospective chart review was conducted including demographics and clinical data from HMV visits and pediatric or adult SMV visits. Clinical variables included scheduling, providers, TRAQs, Patient Health Questionnaire-9 (PHQ9), health maintenance goals, and disease status. The effectiveness of the HMV was accessed by attendance, PHQ9 screening, adherence to health recommendations, and TRAQ scores. Results 140 patients completed at least one HMV. The patient cohort was 80% white and 59% male. Mean age was 18 ± 2 years old at the time of their first HMV. The majority of patients had a primary IBD diagnosis of Crohn’s disease (75%), followed by ulcerative colitis (21%), and unclassified IBD (4%). Most patients had inactive disease (68%) around the time of the first HMV, while a minority had mild (20%) or moderate (12%) disease activity based on PGA. The average TRAQ score at the first HMV visit was 66 ± 17. Patients who completed at least 1 prior HMV (n=8) scored significantly higher on the TRAQ when transferring to the adult care compared to patients (n=29) who were transferred at their first HMV visit (92 vs 83, p<0.05). Of the 56 patients who completed the PHQ9 depression screen, 22 had a positive screen. Of the patients with no prior diagnosis of depression, 36% had a positive screen with the severity of depression ranging from mild to severe. Across all visits, 45 patients were transferred into adult care following a HMV. Conclusions This study demonstrated that a structured HMV prior to transfer may increase transition readiness as assessed by the TRAQ. In addition, new diagnosis of depression was made in a significant portion of patients screened, emphasizing the importance of regular screening for psychological issues. Future studies are needed to validate these findings and potentially move towards a standard template for transition readiness in pediatric IBD patients.

scholarly journals Evaluating a Standardized Transition of Care Process for Pediatric Inflammatory Bowel Disease Patients

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 271
Author(s):  
Jennifer Lynne Shearer ◽  
Sharon Perry ◽  
Nicole Lidyard ◽  
Carolyn Apperson-Hensen ◽  
Sarah DeLozier ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Retrospective Chart Review ◽  
Care Process ◽  
Adult Care ◽  
Health Maintenance ◽  
Positive Screen ◽  
Transition Readiness ◽  
Pediatric Inflammatory Bowel Disease ◽  
Inflammatory Bowel

To reduce lapses in care for pediatric inflammatory bowel disease (IBD) patients approaching adulthood, a health maintenance transition visit (HMV) was developed to supplement standard medical care (SMV). Our aim was to assess the effect of the HMV on transition readiness. A retrospective chart review was conducted at a single center with demographics and clinical data from HMV and SMV visits. Effectiveness of the HMV was assessed by the patient health questionanaire-9 (PHQ-9) and transition readiness assessment questionnaire (TRAQ) scores. A total of 140 patients, 80% Caucasian and 59% male completed an HMV. The mean age was 18 ± 2 years old, and 93% of patients reported inactive or mild disease. Patients who completed at least 1 prior HMV scored significantly higher on the TRAQ when transferring to adult care compared to patients transferred at their first HMV visit (92 vs. 83, p < 0.05). Of patients with no prior depression diagnosis, 36% had a positive screen for depression. A significant relationship was identified between disease status and PHQ-9 (p < 0.05). This study demonstrated a structured HMV increased transition readiness and quantified the significant under-diagnosis of depression in this population, emphasizing the importance of screening. These results indicate depression may affect patients’ transition preparedness.

scholarly journals N24 Prioritised adolescent healthcare transition readiness factors by Canadian inflammatory bowel disease nurses

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S668-S668
Author(s):  
N Rohatinsky ◽  
T Risling ◽  
M Kumaran ◽  
L A Hellsten
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Outcomes ◽  
Bowel Disease ◽  
Transitional Period ◽  
Positive Health ◽  
Adult Care ◽  
Readiness Assessment ◽  
Transition Readiness ◽  
Healthcare Transition ◽  
Inflammatory Bowel

Abstract Background Canada has over 270,000 individuals living with inflammatory bowel disease (IBD). Over 7000 children and adolescents have been diagnosed and these numbers are continuing to increase. Due to the chronic, life long nature of IBD, more adolescents are transitioning from paediatric to adult healthcare environments than ever before. There is great need to ensure that adolescents are properly supported through this transitional period to ensure that their health outcomes are maximised. IBD nurses are integral members of the transition team; however, their perspectives on priority transition readiness factors are limited. Therefore, the purpose of this study was for Canadian IBD nurses to prioritise healthcare transition readiness assessment factors. Methods An anonymous survey was created and distributed to IBD nurses across Canada. Nine transition topic categories with several transition statements within each category were identified based on a previous scoping review and expert opinion. Nurses were asked to rank the top three statements under each category. Results Fifty-six Canadian IBD nurses participated in the survey. The highest priority statement that was most frequently identified as the top selection under each transition topic category is listed below. Conclusion IBD nurses identified key transition readiness factors that will ultimately allow young adults to self-manage their IBD; promote successful transition into adult care; and allow for positive health outcomes.

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

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.

scholarly journals Does inflammatory bowel disease have different characteristics according to stage of adolescence?

2021 ◽  
Vol 14 ◽  
pp. 175628482098667
Author(s):  
Kata Judit Szántó ◽  
Tamás Balázs ◽  
Dóra Mihonné Schrempf ◽  
Klaudia Farkas ◽  
Tamás Molnár
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Severe Disease ◽  
Transition To Adult Care ◽  
Insurance Fund ◽  
Late Adolescent ◽  
Adult Care ◽  
Adolescent Group ◽  
Adolescent Patients ◽  
Inflammatory Bowel

Background: There is a lack of data about demographic and treatment characteristics of adolescent patients with inflammatory bowel disease (IBD). The aim of this retrospective, epidemiological study was to evaluate characteristics and therapeutic features of Hungarian adolescents with IBD. Methods: We analysed the social security databases of the National Health Insurance Fund. Adolescent patients with IBD for whom data from 2009 to 2016 were observable in the database were enrolled. Patients aged 14 to 17 years and 18 to 21 years were defined as middle and late adolescent patients. Results: The incidences of IBD were 20.12 per 100,000 middle adolescent patients and 29.72 per 100,000 late adolescent patients. Admission to gastroenterology department was higher in both groups compared with admissions to surgery department. Mesalazine was used by a high proportion of Crohn’s disease and ulcerative colitis patients. Rates of corticosteroid use were similar in both groups, with a tendency to decrease over time. The need for biologic agents was higher in the middle adolescent patients. The proportion of patients in the middle adolescent group who received anti-TNF therapy showed an increasing tendency. Conclusion: Our data suggest differences in the treatment strategies of gastroenterologists for these age groups. The greater need of anti-TNF therapy among the middle adolescent group indicates that adolescent patients before the transition to adult care may have a more severe disease phenotype. We expect that a strategy of early, effective treatment will significantly ameliorate the subsequent disease course, which is manifested in adult care.

Empowered transitions: Understanding the experience of transitioning from pediatric to adult care among adolescents with inflammatory bowel disease and their parents using photovoice

2021 ◽  
Vol 143 ◽  
pp. 110400
Author(s):  
Jordyn H. Feingold ◽  
Halley Kaye-Kauderer ◽  
Michelle Mendiolaza ◽  
Marla C. Dubinsky ◽  
Laurie Keefer ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Adult Care ◽  
Inflammatory Bowel

Transition of patients with inflammatory bowel disease from pediatric to adult care

2008 ◽  
Vol 32 (5) ◽  
pp. 451-459 ◽  
Author(s):  
A. Dabadie ◽  
F. Troadec ◽  
D. Heresbach ◽  
L. Siproudhis ◽  
M. Pagenault ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Adult Care ◽  
Inflammatory Bowel

The Impact of Transition Readiness and Stress on Patient-Centered Outcomes in Young Adults With Inflammatory Bowel Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kathleen A. Rhodes ◽  
Jean T. Walker ◽  
Lei Zhang ◽  
Kayla L. Carr ◽  
Karen P. Winters ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Young Adults ◽  
Bowel Disease ◽  
Patient Centered ◽  
Transition Readiness ◽  
Inflammatory Bowel ◽  
The Impact

Phenotypic Features and Longterm Outcomes of Pediatric Inflammatory Bowel Disease Patients with Arthritis and Arthralgia

2017 ◽  
Vol 44 (11) ◽  
pp. 1636-1643 ◽  
Author(s):  
Osnat Nir ◽  
Firas Rinawi ◽  
Gil Amarilyo ◽  
Liora Harel ◽  
Raanan Shamir ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Medical Records ◽  
Biologic Therapy ◽  
Joint Involvement ◽  
Pediatric Inflammatory Bowel Disease ◽  
History Of ◽  
Inflammatory Bowel ◽  
Phenotypic Features ◽  
Pediatric Ibd

Objective.The natural history of pediatric inflammatory bowel disease (IBD) patients with joint involvement has not been clearly described. Thus, we aimed to investigate phenotypic features and clinical outcomes of this distinct association.Methods.The medical records of patients with pediatric IBD diagnosed from 2000 to 2016 were reviewed retrospectively. Main outcome measures included time to first flare, hospitalization, surgery, and biologic therapy.Results.Of 301 patients with Crohn disease (median age 14.2 yrs), 37 (12.3%) had arthritis while 44 (14.6%) had arthralgia at diagnosis. Arthritis and arthralgia were more common in women (p = 0.028). Patients with arthritis and arthralgia demonstrated lower rates of perianal disease (2.7% and 4.5% vs 16.9%, p = 0.013), whereas patients with arthritis were more likely to be treated with biologic therapy (HR 2.05, 95% CI 1.27–3.33, p = 0.009). Of 129 patients with ulcerative colitis (UC; median age 13.7 yrs), 3 (2.3%) had arthritis and 16 (12.4%) had arthralgia at diagnosis. Patients with arthralgia were treated more often with corticosteroids (p = 0.03) or immunomodulator therapies (p = 0.003) compared with those without joint involvement. The likelihood to undergo colectomy was significantly higher in patients with arthralgia (HR 2.9, 95% CI 1.1–7.4, p = 0.04). During followup (median 9.0 yrs), 13 patients developed arthritis (3.3%). Arthralgia at diagnosis was a significant predictor for the development of arthritis during followup (HR 9.0, 95% CI 2.86–28.5, p < 0.001).Conclusion.Pediatric IBD patients with arthritis have distinct phenotypic features. Arthralgia at diagnosis is a predictor for colectomy in UC and a risk factor for the development of arthritis during followup.

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

2020 ◽  
Author(s):  
Antonio Corsello ◽  
Daniela Pugliese ◽  
Fiammetta Bracci ◽  
Daniela Knafelz ◽  
Bronislava Papadatou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Observational Study ◽  
Bowel Disease ◽  
Transition Process ◽  
Major Surgery ◽  
Adult Care ◽  
Inflammatory Bowel ◽  
The Mean

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.

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