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transition of pediatric to adult care in inflammatory bowel disease: Is it as easy as 1, 2, 3?

World Journal of Gastroenterology 2017年第20期23卷 3624-3631页

作者： Anita Afzali Ghassan Wahbeh Division of Gastroenterology University of WashingtonHarborview Medical CenterSeattleWashington Division of Gastroenterology Seattle Children's HospitalUniversity of WashingtonSeattleWashington

Inflammatory bowel disease(IBD)is a heterogeneous group of chronic diseases with a rising prevalence in the pediatric population,and up to 25%of IBD patients are diagnosed before 18 years of *** with IBD tend to have more severe and extensive disease and eventually require graduation from pediatric care toadult *** transition of patients from pediatric to adult gastroenterologists requires careful preparation and coordination,with involvement of all key players to ensure proper collaboration of care and avoid interruption in *** can be challenging and associated with gaps in delivery of *** pediatric and adult health paradigms have inherent differences between health care models,as well as health care priorities in *** readiness of the young adult also influences this transition of care,with often times other overlaps in life events,such as school,financial independence and moving away from *** patients are therefore at higher risk for poorer clinical disease *** aim of this paper is to review concepts pertinent to transition of care of young adults with IBD to adult care,and provides resources appropriate for an IBD pediatric to adult transition of care model.

关键词： Inflammatory bowel disease Adolescents Young adults transition care transition to adult care

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Outcomes and patients' perspectives of transition from paediatric to adult care in inflammatory bowel disease

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World Journal of Gastroenterology 2016年第8期22卷 2611-2620页

作者： Alice L Bennett David Moore Peter A Bampton Robert V Bryant Jane M Andrews Department of Gastroenterology Royal Adelaide Hospital North Terrace Adelaide SA 5000 Australia Department of Gastroenterology Flinders Medical Centre Flinders Drive Bedford Park SA 5042 Australia School of Medicine University of Adelaide Adelaide SA 5000 Australia Department of Gastroenterology Women's and Children's Hospital Adelaide SA 5006 Australia School of Medicine Flinders University Adelaide SA 5001 Australia

AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their ***: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition ***: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key ***: transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.

关键词： transition care Crohn’ s disease Ulcerative colitis Chronic illness Inflammatory bowel disease Patient perspectives Disease outcomes

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