Purpose of Review <p>Transition of care for pediatric patients with inflammatory bowel disease (IBD) is a complex, longitudinal process that requires proactive coordination between pediatric and adult gastroenterology teams. This review outlines current strategies for transition, including suggested models and validated assessment tools, as well as highlights the complexities of this process.</p> Recent Findings <p>Recent guidelines suggest that structured, multidisciplinary programs may improve clinical and psychosocial outcomes, although evidence is limited. Suggested models include combined clinics with both adult and pediatric providers, establishing a medical home, and the development of educational workshops. Assessment tools and resources are available for both patients and providers to assess a patient’s readiness to transition, as well as to assist in the transition process. Despite these resources, there remain ongoing gaps in the literature that include outcomes-based research and the lack of standardized metrics to define transition success. Moreover, most studies exclude patients with IBD who also have developmental delays, psychiatric co-morbidities, or other complex needs, thus widening these gaps and making this population more vulnerable to worse outcomes at the time of transition.</p> Summary <p>In order to improve transition and disease outcomes, providers should start the transition process early, use a multi-disciplinary approach, utilize readiness tools, involve the family or caregivers and the patient, and optimize communication between providers to transfer medical information to the new care team. Future research should prioritize quality improvement strategies and implementation science to better achieve successful transition of care for IBD patients to ensure sustained engagement in adult care.</p>

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Pediatric to Adult Transition of Care in Inflammatory Bowel Disease: Keeping Patients on Track

  • Nicole Zeky,
  • Jennifer Hellmann,
  • Kaitlin G Whaley

摘要

Purpose of Review

Transition of care for pediatric patients with inflammatory bowel disease (IBD) is a complex, longitudinal process that requires proactive coordination between pediatric and adult gastroenterology teams. This review outlines current strategies for transition, including suggested models and validated assessment tools, as well as highlights the complexities of this process.

Recent Findings

Recent guidelines suggest that structured, multidisciplinary programs may improve clinical and psychosocial outcomes, although evidence is limited. Suggested models include combined clinics with both adult and pediatric providers, establishing a medical home, and the development of educational workshops. Assessment tools and resources are available for both patients and providers to assess a patient’s readiness to transition, as well as to assist in the transition process. Despite these resources, there remain ongoing gaps in the literature that include outcomes-based research and the lack of standardized metrics to define transition success. Moreover, most studies exclude patients with IBD who also have developmental delays, psychiatric co-morbidities, or other complex needs, thus widening these gaps and making this population more vulnerable to worse outcomes at the time of transition.

Summary

In order to improve transition and disease outcomes, providers should start the transition process early, use a multi-disciplinary approach, utilize readiness tools, involve the family or caregivers and the patient, and optimize communication between providers to transfer medical information to the new care team. Future research should prioritize quality improvement strategies and implementation science to better achieve successful transition of care for IBD patients to ensure sustained engagement in adult care.