Year 2019 / Volume 111 / Number 11
Original
Status of transition care in inflammatory bowel disease in Spain. Different medical perspectives

833-838

DOI: 10.17235/reed.2019.6310/2019

César Sánchez Sánchez, María del Mar Tolín Hernani, Guillermo Álvarez Calatayud, María del Carmen Miranda Cid, Víctor M. Navas López, Ignacio Marín Jiménez, Luis Alberto Menchen, Paloma García Fernández, Ana Merino Sánchez-Cañete,

Abstract
Introduction: transition is important for a successful follow-up of adolescents with inflammatory bowel disease (IBD). The objectives of the study were to establish the situation of transition in Spain and to identify needs, requirements and barriers to transition from pediatric and adult gastroenterologist perspectives. Methods: a structured survey for self-completion using the REDCap platform was distributed via the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) and the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU). The questionnaire contained closed and ranked questions concerning transition, perceived needs, organizational, clinician and patient related barriers to transition. Results: one hundred and forty surveys were answered, 53% in pediatrics (PG) and 47% from adult gastroenterologists (AG) among 90 hospitals; 66% of them were reference centers. There was a higher response from pediatricians (18.2%) versus adult gastroenterologists (8.3%) (p = 0.03). A structured transition program is adequate in 42.2% centers. A well-structured transition was perceived as very important by 79.5% of PG and 63% of AG (p = 0.03). A higher proportion of both groups identified inadequacies in the preparation of adolescents for transfer (43% and 38%, p = ns). The main deficit areas were the lack of knowledge about disease and treatment as well as the lack of self-advocacy and care coordination. Lack of resources, time and critical mass of patients were the highest ranked barriers by both groups. AG and PG (54% and 55%) highlighted suboptimal training in adolescent medicine. Conclusions: in Spain, nearly half of the centers have developed a structured transition program. Lack of training, time and insufficient resources are the main barriers for a successful transition.
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References
1. Martín de Carpi J, Rodríguez A, Ramos E et al. Increasing Incidence of Pediatric Inflammatory Bowel Disease in Spain (1996–2009). Inflamm Bowel Dis. 2013;19(1):73-80.
2. Cole R, Ashok D, Razack A, et al. Evaluation of Outcomes in Adolescent Inflammatory Bowel Disease Patients Following Transfer From Pediatric to Adult Health Care Services: Case for Transition. J Adolesc Heal. 2015;57(2):212-217.
3. Blum RW, Farell D, Hodgman Ch, et al. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health. 1993;14(7):570-576.
4. Goodhand J, Hedin CR, Croft NM, et al. Adolescents with IBD: the importance of structured transition care. J Crohns Colitis. 2011;5(6):509-519.
5. Wright EK, Williams J, Andrews JM, et al. Perspectives of paediatric and adult gastroenterologists on transfer and transition care of adolescents with inflammatory bowel disease. Intern Med J. 2014;44(5):490-496.
6. Paine CW, Stollon NB, Lucas MS, et al. Barriers and Facilitators to Successful Transition from Pediatric to Adult Inflammatory Bowel Disease Care from the Perspectives of Providers. Inflamm Bowel Dis. 2014;20(11):2083-2091.
7. Martín Martínez B, Bautista A, Sánchez Sánchez C. El Adolescente y la enfermedad Inflamatoria Intestinal: Consulta de Transición. En: Sánchez Sánchez C, Marín-Jiménez I, Tolín Hernani M, Morales Pérez JL editores. Enfermedad Inflamatoria Intestinal en Pediatría. Madrid: Ergon; 2013. p. 429-438.
8. Fishman LN, Mitchell PD, Lakin PR, et al. Are Expectations Too High for Transitioning Adolescents With Inflammatory Bowel Disease? Examining Adult Medication Knowledge and Self-Management Skills. J Pediatr Gastroenterol Nutr. 2016;63(5):494-499.
9. Maddux MH, Ricks S, Bass J. Patient and Caregiver Perspectives on Transition and Transfer. Clin Pediatr (Phila). 2017;56(3):278-283.
10. Sebastian S, Jenkins H, McCartney S, et al. The requirements and barriers to successful transition of adolescents with inflammatory bowel disease: differing perceptions from a survey of adult and paediatric gastroenterologists. J Crohns Colitis. 2012;6(8):830-844.
11. Gray WN, Maddux MH. Current Transition Practices in Pediatric IBD. Inflamm Bowel Dis. 2016;22(2):372-379.
12. Hait EJ, Barendse RM, Arnold JH, et al. Transition of Adolescents With Inflammatory Bowel Disease From Pediatric to Adult Care: A Survey of Adult Gastroenterologists. J Pediatr Gastroenterol Nutr. 2009;48(1):61-65.
13. Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381.
14. McNicholl AG, Gisbert JP. Research to the N-Power: The Strengths of Networked Clinical Collaboration in Spain. Am J Gastroenterol. 2017;112(12):1761-1764.
15. Ministerio de Sanidad C y BS. Catálogo Nacional de Hospitales - Ciudadanos - Sistema Nacional de Salud - Hospitales. https://www.mscbs.gob.es/ciudadanos/prestaciones/centrosServiciosSNS/hospitales/home.htm. Accessed December 31, 2018.
16. Yerushalmy-Feler A, Ron Y, Barnea E, et al. Adolescent transition clinic in inflammatory bowel disease: quantitative assessment of self-efficacy skills. Eur J Gastroenterol Hepatol. 2017;29(7):831-837.
17. Escher JC. Transition from Pediatric to Adult Health Care in Inflammatory Bowel Disease. Dig Dis. 2009;27(3):382-386.
18. Baldassano R, Ferry G, Griffiths A, et al. Transition of the patient with inflammatory bowel disease from pediatric to adult care: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2002;34(3):245-248.
19. Hait E, Arnold JH, Fishman LN. Educate, communicate, anticipate-practical recommendations for transitioning adolescents with IBD to adult health care. Inflamm Bowel Dis. 2006;12(1):70-73.
20. Brooks AJ, Smith PJ, Cohen R, et al. UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care. Gut. 2017;66(6):988-1000.
21. Sánchez C, Alvarez Calatayud G, Tolin M , et al. La Transición de Pacientes Pediátricos a La Edad Adulta. En: López Calleja A, Cano Sanz N, editores. Guía Práctica de Enfermería En EII. Inspira Network: Madrid; 2017. p. 87-95.
22. Al-Jahdali E, Mosli M, Saadah O. A cross-sectional survey of Saudi gastroenterologists: Transition strategies for adolescents with inflammatory bowel disease. Saudi J Gastroenterol 2017;23(4):233-237.
23. Strohl M, Zhang X, Lévesque D, Bessissow T. Transition care in inflammatory bowel disease: A needs assessment survey of Quebec gastroenterologists and allied nurses. World J Gastrointest Pharmacol Ther. 2017;8(3):186-192.
24. Dabadie A, Troadec F, Heresbach D, et al. Transition of patients with inflammatory bowel disease from pediatric to adult care. Gastroenterol Clin Biol. 2008;32:451-459.
25. Clarke T, Lusher J. Transitioning patients with inflammatory bowel disease (IBD) from adolescent to adult services: a systematic review. Frontline Gastroenterol. 2016;7(4):264-270.
26. van Rheenen PF, Aloi M, Biron IA, et al. European Crohn’s and Colitis Organisation Topical Review on Transitional Care in Inflammatory Bowel Disease. J Crohns Colitis. 2017;11(9):1032-1038.
27. Elli L, Maieron R, Martelossi S, et al. Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology. Dig Liver Dis. 2015;47(9):734-740.
28. Bollegala N, Nguyen GC. Transitioning the Adolescent with IBD from Pediatric to Adult Care: A Review of the Literature. Gastroenterol Res Pract. 2015;2015:853530.
29. Fishman LN, Houtman D, van Groningen J, et al. Medication Knowledge: an Initial Step in Self-management for Adolescents and Young Adults with Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr. 2011;53(6):1.
30. Zijlstra M, De Bie C, Breij L, et al. Self-efficacy in adolescents with inflammatory bowel disease: A pilot study of the “IBD-yourself”, a disease-specific questionnaire.J Crohns Colitis. 2013 Oct;7(9):e375-85. doi: 10.1016/j.crohns.2013.02.017.
31. Bennett AL, Moore D, Bampton PA, et al. Outcomes and patients’ perspectives of transition from paediatric to adult care in inflammatory bowel disease. World J Gastroenterol. 2016;22(8):2611-2620.
32. Blázquez ML, Hernani MT, Calatayud GÁ, et al. Transition Care Program of Adolescents With Inflammatory Bowel Disease: Perceptions From A Survey for Patients. Inflamm Bowel Dis. 2018. June 5. pii: 5033090. doi: 10.1093.
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Sánchez Sánchez C, Tolín Hernani M, Álvarez Calatayud G, Miranda Cid M, Navas López V, Marín Jiménez I, et all. Status of transition care in inflammatory bowel disease in Spain. Different medical perspectives. 6310/2019


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Publication history

Received: 31/03/2019

Accepted: 19/05/2019

Online First: 30/09/2019

Published: 07/11/2019

Article revision time: 37 days

Article Online First time: 183 days

Article editing time: 221 days


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