Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology

Abstract

In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood.

Transitional care for patients with surgical pediatric hepatobiliary disease: Choledochal cysts and biliary atresia

“…Elli et al . propose transition of care recommendations for patients with chronic liver disease, which include BA, Alagille's syndrome, Alpha‐1 antitrypsin deficiency, and liver transplantation . While CDCs are not included in their evaluated population, the authors' recommendations remain generalizable and can be applied to this cohort.…”

“…Elli et al propose transition of care recommendations for patients with chronic liver disease, which include BA, Alagille's syndrome, Alpha-1 antitrypsin deficiency, and liver transplantation. 28 While CDCs are not included in their evaluated population, the authors' recommendations remain generalizable and can be applied to this cohort. These recommendations include beginning the transition process between ages 16 and 18 years, informing and including the patient in the transition process and coordinating combined visits between pediatric and adult providers (specifically gastroenterologists) over several visits within a 12-month period.…”

COMPLICATED Crohn's disease IN ADOLESCENTS: FEATURES, INDICATIONS FOR SURGICAL TREATMENT, DIFFICULTY OF TRANSITION of care (review article)

“…В 2015 году Ассоциация детских и взрослых гастроэнтерологов (Италия) опубликовала основные положения консенсуса по переходному периоду во взрослое здравоохранение подростков с тяжелой гастроэнтерологической патологией (ВЗК, аутоиммунными гепатитами, билиарной атрезией, целиакией и т.п.) [57]. Юные пациенты характеризуются низким уровнем приверженности к терапии и должны быть строго мониторированы перед транзитом во взрослую сеть.…”

Challenges in gluten‐free diet in coeliac disease: Prague consensus

“…This process is characterised by mental, physical, cultural and psychological aspects and was dealt as a priority by the American Academy of Pediatrics in 2011 . However, specifically, the recommendations for the transition in CD are rare and not topic oriented . This is the reason why the Prague consensus report team should be congratulated for undertaking the task .…”