Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand

Abstract Background and Aim Children and adolescents account for approximately 14% of inflammatory bowel disease (IBD) diagnoses. At an appropriate age and level of development adolescents with IBD have their care transferred from the pediatric to adult clinical team during a process termed “transit...

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Main Authors: Angharad Vernon‐Roberts, Patrick Chan, Britt Christensen, Andrew S Day, Rachael Havrlant, Edward Giles, Astrid‐Jane Williams
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:JGH Open
Subjects:
Online Access:https://doi.org/10.1002/jgh3.13032
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author Angharad Vernon‐Roberts
Patrick Chan
Britt Christensen
Andrew S Day
Rachael Havrlant
Edward Giles
Astrid‐Jane Williams
author_facet Angharad Vernon‐Roberts
Patrick Chan
Britt Christensen
Andrew S Day
Rachael Havrlant
Edward Giles
Astrid‐Jane Williams
author_sort Angharad Vernon‐Roberts
collection DOAJ
description Abstract Background and Aim Children and adolescents account for approximately 14% of inflammatory bowel disease (IBD) diagnoses. At an appropriate age and level of development adolescents with IBD have their care transferred from the pediatric to adult clinical team during a process termed “transition”. The study aim was to survey pediatric gastroenterologists throughout Australasia to identify commonality in the transition process to contribute to standardized guideline development. Methods A descriptive survey captured key variables: transition clinic format, process and infrastructure, transition assessments, and guidelines. The survey was distributed electronically to 59 Pediatric Gastroenterologists throughout Australasia in January 2023. Results Seventeen (29%) clinicians completed the survey: Australia 13 (76%). New Zealand 4 (24%). Thirteen (76%) respondents had access to a dedicated IBD transition clinic. Adolescents attended transition clinics 1–7 times, and the main processes transferred were: prescription provision, biologic appointments, and adult team contacts. Transition was first discussed age 13–15 years (53%), or 16–18 years (47%), with the main discussion topics including: continuing adherence (88%), smoking (59%), alcohol use (59%), recreational drug use (59%). Transition readiness assessments were done infrequently (24%). The minority (24%) used formal guidelines to inform the transition process, but 15 (88%) considered the development of a standardized Australasian guideline as beneficial/extremely beneficial. Conclusions This survey highlighted that transition care for adolescents with IBD is variable across Australasia. Australasian guideline development may optimize the transition process for adolescents with IBD and improve their longitudinal outcomes.
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spelling doaj.art-68ed1a4494eb41df9f5cdb508394b5542024-02-07T15:12:06ZengWileyJGH Open2397-90702024-01-0181n/an/a10.1002/jgh3.13032Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New ZealandAngharad Vernon‐Roberts0Patrick Chan1Britt Christensen2Andrew S Day3Rachael Havrlant4Edward Giles5Astrid‐Jane Williams6Department of Paediatrics University of Otago Christchurch New ZealandDepartment of Gastroenterology Liverpool Hospital Sydney AustraliaDepartment of Gastroenterology Royal Melbourne Hospital Melbourne AustraliaDepartment of Paediatrics University of Otago Christchurch New ZealandAgency for Clinical Innovation NSW Health Sydney AustraliaDepartment of Paediatrics Monash Children's Hospital Melbourne AustraliaDepartment of Gastroenterology Liverpool Hospital Sydney AustraliaAbstract Background and Aim Children and adolescents account for approximately 14% of inflammatory bowel disease (IBD) diagnoses. At an appropriate age and level of development adolescents with IBD have their care transferred from the pediatric to adult clinical team during a process termed “transition”. The study aim was to survey pediatric gastroenterologists throughout Australasia to identify commonality in the transition process to contribute to standardized guideline development. Methods A descriptive survey captured key variables: transition clinic format, process and infrastructure, transition assessments, and guidelines. The survey was distributed electronically to 59 Pediatric Gastroenterologists throughout Australasia in January 2023. Results Seventeen (29%) clinicians completed the survey: Australia 13 (76%). New Zealand 4 (24%). Thirteen (76%) respondents had access to a dedicated IBD transition clinic. Adolescents attended transition clinics 1–7 times, and the main processes transferred were: prescription provision, biologic appointments, and adult team contacts. Transition was first discussed age 13–15 years (53%), or 16–18 years (47%), with the main discussion topics including: continuing adherence (88%), smoking (59%), alcohol use (59%), recreational drug use (59%). Transition readiness assessments were done infrequently (24%). The minority (24%) used formal guidelines to inform the transition process, but 15 (88%) considered the development of a standardized Australasian guideline as beneficial/extremely beneficial. Conclusions This survey highlighted that transition care for adolescents with IBD is variable across Australasia. Australasian guideline development may optimize the transition process for adolescents with IBD and improve their longitudinal outcomes.https://doi.org/10.1002/jgh3.13032adolescentscolitiscrohn's diseaseguidelinesIBDtransition
spellingShingle Angharad Vernon‐Roberts
Patrick Chan
Britt Christensen
Andrew S Day
Rachael Havrlant
Edward Giles
Astrid‐Jane Williams
Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand
JGH Open
adolescents
colitis
crohn's disease
guidelines
IBD
transition
title Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand
title_full Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand
title_fullStr Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand
title_full_unstemmed Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand
title_short Transitional care of adolescents with inflammatory bowel disease to adult services varies widely across Australia and New Zealand
title_sort transitional care of adolescents with inflammatory bowel disease to adult services varies widely across australia and new zealand
topic adolescents
colitis
crohn's disease
guidelines
IBD
transition
url https://doi.org/10.1002/jgh3.13032
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