Background The transition from pediatric to adult care is associated with changes centered around the patient taking responsibility for their health. As the incidence of childhood-onset inflammatory bowel disease (IBD) is increasing, it is important to address gaps in transition literature—specifically, the indicators signifying achievement of transition success. The study objective was to define transition success according to patients, parents, and health care providers involved in IBD transition. Methods This study used the method of qualitative description to conduct semi-structured interviews with patients, parents, and health care providers. During interviews, demographic information was collected, and interviews were recorded and transcribed. Data analysis was conducted independently of each group using latent content analysis. Participant recruitment continued until thematic saturation was reached within each group. Results Patients, parents, and health care providers all defined transition success with the theme of independence in one’s care. The theme of disease management emerged within parent and provider groups, whereas the theme of relationship with/ trust in adult care team was common to patients and parents. Additional themes of care team management, general knowledge, care stability, and health outcomes emerged within specific groups. Conclusion This study demonstrated differences between how patients, parents, and health care providers view transition success. This finding reveals the value of using a multifaceted definition of transition success with input from all stakeholders. Further research should prioritize the identification of factors common to patients who do not reach transition success as defined by patients, their parents, and providers.

Purpose: Approximately 25% of inflammatory bowel disease (IBD) patients are diagnosed in childhood and the incidence is increasing. Thus, more patients will transition to adult care in the future. Within the literature, transition readiness has been deemed important to achieving a successful transition; however, it is unclear what outcomes define success. This scoping review aims to summarize the literature on outcomes surrounding transition from pediatric to adult care in patients with IBD. Methods: A scoping review was conducted with the following steps: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarizing, and reporting results, and (6) consultation with an additional researcher. Studies were identified from 5 databases and were included in part if (1) IBD was a disease of interest, (2) referred to transition as the movement and adjustment from pediatric to adult care, and (3) evaluated patient outcomes up to 5 years after first adult appointment and/or defined a successful or unsuccessful transition. Results: Twenty-six peer-reviewed studies were included. Four studies defined transition success, while 2 studies defined an unsuccessful transition. Transition outcomes were categorized into these 6 themes: being comfortable in adult care (n = 4); health care utilization (n = 19); disease management (n = 15); knowledge (n = 5); quality of life (n = 6); self-efficacy (n = 7). Conclusions: Most studies evaluated transition outcomes by themes of health care utilization (n = 19) and disease management (n = 15). Future research should focus on engaging patients along with providers in order to create a consensus on indicators of transition success.

Background Patients with inflammatory bowel disease (IBD) in childhood are a vulnerable population. Compared to patients diagnosed in adulthood, they may present more often with extensive disease, delayed growth, and more frequently have perianal disease. Eventually, these patients will transfer care from the pediatric to the adult system, which has been associated with medication nonadherence and increase in health care utilization. Within the literature, travel distance has been cited as a barrier to accessing health care; however, understanding its’ impact on this vulnerable patient population has not been well-established. Purpose The study objective was to characterize differences between patients transferring from pediatric to adult care based on distance from an IBD center. To achieve this, the study aims to measure associations between distance to clinic and smoking status, anxiety and depression, history of surgery, and biologics at the time of first appointment in adult care. Method A retrospective cross-sectional study is ongoing using electronic medical charts for patients who transferred from pediatric to adult care from January 1, 2014 – October 4, 2022. Transfer was defined as the patient’s first appointment in adult care at the University of Alberta’s IBD clinic. Distance was measured by driving distance from the patient’s postal code to the postal code of the IBD clinic. Distance was categorized as being <50km from IBD clinic and >50km. Binary outcome variables collected at time of transfer included reported biologic use, anxiety and depression, smoking status, and history of surgeries. Descriptive and inferential statistics were used to analyze data. Result(s) Of the 185 electronic medical charts were reviewed, 46 (24.9%) patients lived >50km from clinic. The median age at diagnosis for the >50km group was 14.5 (IQR: 15.9-13.6), 41% were female sex, 54% had Crohn disease, 41% had ulcerative colitis (UC), and 26% had completed a fecal calprotectin within the last 6 months. The median age at diagnosis of the 139 patients living <50km from clinic was 14.3 (IQR:15.9-12.5), 45% were female sex, 60% had Crohn disease, 32% had UC, and 59% had completed a fecal calprotectin. Of those who had a fecal calprotectin, in group 1, 26% had a result over >250 ug/g, compared to 60% in the reference group. Univariate analysis (Table 1) showed that those living further than 50 km were more likely than those closer to engage in daily smoking (OR~4.7). Weaker and lack of associations were seen with anxiety and depression (OR~1); being on biologics (OR~0.7); history of surgical intervention (OR~2.2). Image Conclusion(s) When smoking status was reported, patients > 50km away from clinic were 4.7 times more likely to engage in daily smoking at time of transfer compared to those patients within 50km from the clinic. By acknowledging and understanding potential differences and similarities between patients characterized by geographical location, we can use this research to inform personalized care plans. Disclosure of Interest None Declared