Transition Readiness Skills Acquisition in Adolescents and Young Adults with Inflammatory Bowel Disease

Gray, Wendy N.; Holbrook, Erin; Morgan, Pamela J.; Saeed, Shehzad Ahmed; Denson, Lee A.; Hommel, Kevin A.

doi:10.1097/mib.0000000000000352

Cited by 75 publications

(89 citation statements)

References 17 publications

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“…These findings can be used in clinical care, in clinical settings with AYA of a similar demographic, in order to benchmark AYA’s skills in relation to their peers, ensure that they are on track in their development, and as a reference point for the development of clinical interventions teaching skill mastery earlier and in a more step-wise fashion. Our results are consistent with previous literature showing a significant and positive relationship between age and skill acquisition[8,11-13]. They add to these findings, by showing that age also predicts mastery of skills over time.…”

Section: Discussionsupporting

confidence: 93%

“…Despite an increase in transition-readiness initiatives, AYA with IBD often do not achieve full healthcare independence before transfer to adult providers[6-8]. There is evidence that a majority of adults with IBD regularly solicit assistance from a family member, friend, or spouse with picking up medications and developing a list of questions for their physician[6].…”

Section: Introductionmentioning

confidence: 99%

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Chronological age when healthcare transition skills are mastered in adolescents/young adults with inflammatory bowel disease

Stollon¹,

Zhong²,

Ferris³

et al. 2017

WJG

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AIMTo describe the longitudinal course of acquisition of healthcare transition skills among adolescents and young adults with inflammatory bowel diseases.METHODSWe recruited adolescents and young adults (AYA) with inflammatory bowel diseases (IBD), from the pediatric IBD clinic at the University of North Carolina. Participants completed the TRxANSITION Scale™ at least once during the study period (2006-2015). We used the electronic medical record to extract participants’ clinical and demographic data. We used ordinary least square regressions with robust standard error clustered at patient level to explore the variations in the levels and growths of healthcare transition readiness.RESULTSOur sample (n = 144) ranged in age from 14-22 years. Age was significantly and positively associated with both the level and growth of TRxANSITION Scale™ scores (P < 0.01). Many healthcare transition (HCT) skills were acquired between ages 12 and 14 years, but others were not mastered until after age 18, including self-management skills.CONCLUSIONThis is one of the first studies to describe the longitudinal course of HCT skill acquisition among AYA with IBD, providing benchmarks for evaluating transition interventions.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Chronological age when healthcare transition skills are mastered in adolescents/young adults with inflammatory bowel disease

Stollon¹,

Zhong²,

Ferris³

et al. 2017

WJG

View full text Add to dashboard Cite

show abstract

“…15 A recent study at a single pediatric institution showed that most IBD patients on the verge of transferring to adult care did not demonstrate adequate transition readiness with deficits in self-advocacy and self-management skills. 16 Overall, pediatric providers reported similar perception of importance of transition related knowledge and skills as their adult counterparts. However, pediatric providers indicated that attending appointments alone would be important to adult providers, while the previous survey of adult providers showed that most did not consider this necessary.…”

Section: Discussionmentioning

confidence: 74%

Transitions in Pediatric Gastroenterology

Bensen

McKenzie

Fernandes

et al. 2016

J. pediatr. gastroenterol. nutr.

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“…Gray and colleagues evaluated 195 patients with the TRAQ (transition readiness Assessment questionnaire) and found only 5.6% of patients demonstrated transition readiness. [18] Whitfield and colleagues assessed 67 patients aged 10–21 and found some tasks but not communication with health care providers showed improvement with age but not duration of illness. (19) van Groningren and colleagues studied over 400 patients over the age of 10 and noted age-related improvements but still showed a significant proportion relying on parents for these tasks above the age of 18.…”

Section: Discussionmentioning

confidence: 99%

“…In one elegant study, the benchmarks are set by expert opinion involving both adult and pediatric providers at mastery of 90% of the skills. [18]…”

Section: Discussionmentioning

confidence: 99%

Are Expectations Too High for Transitioning Adolescents With Inflammatory Bowel Disease? Examining Adult Medication Knowledge and Self‐Management Skills

Fishman

Mitchell

Lakin

et al. 2016

J. pediatr. gastroenterol. nutr.

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Objective Transition readiness assessment has focused attention on adolescent knowledge and skills, but data-driven benchmarks have not been established. Methods Patients with IBD, aged 25–55 years, attending an outpatient gastroenterology clinic, were recruited to complete a voluntary, confidential survey asking patients to recall medications and potential side effects, and to rate their degree of independence performing health maintenance tasks. Results The 141 respondents (48% response rate) had mean age of 36 years with median disease duration of 11 years. They were 60% female, 54% had Crohn’s disease, and 23% were diagnosed before age 18. Nearly all patients were fully independent answering doctor’s questions during the visit (93%) and scheduling office visits (92%). Excluding pharmacy pick up, full independence seen in only 57%, while 16% significantly delegated tasks. No differences by gender, disease type, medication class, age at disease onset, or disease duration were found across levels of self-management. Almost all (97%) respondents could recall medication name, while fewer were able to recall dose (63%) or frequency (65%). Side effect knowledge was poor; among 81 patients on a biologic or immunomodulator, only 17 (21%) cited cancer and 22 (27%) cited infection. Conclusions Adolescent IBD transition programs now have empiric data from this study about adult benchmarks for independence in self-management skills. Further research can establish which skills correlate with medication adherence and active collaboration with the medical team. This study also exposes important gaps in medication risk knowledge and may allow improved patient education for subgroups of adult IBD patients.

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Transition Readiness Skills Acquisition in Adolescents and Young Adults with Inflammatory Bowel Disease

Cited by 75 publications

References 17 publications

Chronological age when healthcare transition skills are mastered in adolescents/young adults with inflammatory bowel disease

Chronological age when healthcare transition skills are mastered in adolescents/young adults with inflammatory bowel disease

Transitions in Pediatric Gastroenterology

Are Expectations Too High for Transitioning Adolescents With Inflammatory Bowel Disease? Examining Adult Medication Knowledge and Self‐Management Skills

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