Transition of children with inflammatory bowel disease: Big task, little evidence

Abstract

Children with chronic long-term disorders need to move to the adult practice at some point in their life. Establishing a smooth and efficient transition process is a complicated task. Transition of medical care to adult practice is defined as the purposeful planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adultoriented health care systems. This step is of the utmost importance for several reasons. There is an obvious deficiency of research in this area especially when it comes to pediatric inflammatory bowel disease (IBD). There is a considerable difference in individual practice among different centers. Also, age of transition varies among different countries and sometimes, even within the same country, transition age may vary among different provinces and districts! Interestingly, local politics and many factors other than children's welfare often play a role in deciding the age that older children move to adult practice at. This review discusses transition of children with IBD in view of the available evidence.

Evaluation of Outcomes in Adolescent Inflammatory Bowel Disease Patients Following Transfer From Pediatric to Adult Health Care Services: Case for Transition

“…Hence, a recent review suggested that the introduction of transition care in IBD patients is a difficult task with limited evidence [12]. However, there is broad consensus from professional surveys, including our own large survey of adult and pediatric gastroenterologists [6], in transition care as an essential requirement in this group of patients.…”

UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care

“…The published guidance for specific models of transition lacks a strong evidence base and originates from expert opinion as a result of weak studies involving small patient numbers, bias and multiple methodological flaws within the data sets. 32 44 46 47 …”

Barriers and Facilitators to Successful Transition from Pediatric to Adult Inflammatory Bowel Disease Care from the Perspectives of Providers

“…15–19 Yet, evidence-based recommendations for IBD transition are lacking. 3,5,7,8 Research that provides an in-depth understanding of how each stakeholder contributes to and defines outcomes of transition for AYAs with IBD is a necessary step to establishing evidence-based recommendations.…”