Can a transition clinic bridge the gap between paediatric and adult inflammatory bowel disease care models?

Abstract

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Transitional Care for Patients with Inflammatory Bowel Disease: Japanese Experience

“…Many previous studies have identified various barriers to a seamless transfer of care, as shown in Table 1 [5, 13, 16, 18, 19, 27]. These cover a range of specialists such as healthcare providers, patients, guardians, and social systems and may be single or multiple.…”

“…One of the ideal models for support of patients with childhood-onset IBD during the transition period is to implement an outpatient-based transitional care clinic run by a multidisciplinary team [27]. Although there is no common definition of a transition clinic and the settings are notably heterogeneous [17], a multidisciplinary approach and good interaction among the various stakeholders are potential keys of the success of transition [5]. In some circumstances, it may be difficult to set up a transitional clinic in some institutions due to territorial dispersion (regional specifics) or lack of medical resources.…”

“…Moreover, it is very important to regularly monitor the transition process for both the patient and provider, in order to optimize and individualize the outcome. Transition takes time and should be personalized according to the needs, personality, and clinical history of the patients involved [5].…”

“…IBD is diagnosed before the age of 18 years in approximately 25% of all patients; approximately one-quarter of all affected children and adolescents are under the age of 10 years at diagnosis [4]. In other words, IBD occurs at a delicate time in a child’s physical and psychosocial development and can impact on education, employment, and social integration [5]. Deficiencies in transitional care during a particularly critical phase can result in treatment interruptions, insufficient treatment adherence, and an increased frequency of complications that are probably avoidable [6].…”

“…Deficiencies in transitional care during a particularly critical phase can result in treatment interruptions, insufficient treatment adherence, and an increased frequency of complications that are probably avoidable [6]. Given the increasing incidence of childhood-onset IBD and the lifelong impact of the disease, transitional care for affected patients is critical to ensure continuity of the care and promote health literacy [5]. There is broad consensus that the transition process ought to be well coordinated with the support of a multidisciplinary team [7].…”