Transitional care for inflammatory bowel disease: A survey of Japanese pediatric gastroenterologists

Abstract

Background In 2019 we reported the results of a Japanese national survey designed to explore the views of adult gastroenterologists regarding transitional care for patients with childhood‐onset inflammatory bowel disease (IBD). For the present study, we conducted a similar survey of pediatric gastroenterologists to compare the views of the two sets of specialists. Methods The survey conducted in 2019 involved 48 representative members of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition. They were contacted by conventional mail and their answers were not anonymized. Respondents who had already referred patients with IBD to adult gastroenterologists were asked in a questionnaire to rank the importance of specific statements on a Likert scale. Results The response rate was 79% and 29 (60%) of the respondents had experienced transitional care for patients with IBD. Transfer to adult care was considered by 90% of the respondents to be the ideal form of medical care for adolescents/young adults with IBD. However, 59% of the respondents had experienced some degree of difficulty when making referrals for such care. The majority of pediatric gastroenterologists considered that the ideal age for transfer was 18–22 years. Among the respondents, physicians at municipal hospitals considered that the presence of diseases other than IBD and a shortage of manpower were significantly more important issues than other practice settings. Conclusions The present survey revealed that the general views regarding transitional care for IBD between pediatric and adult gastroenterologists were similar, except for the appropriate time for transfer. The results underline the importance of preparing a transition program appropriate to practice settings.

Transitional care for inflammatory bowel disease in Japan: To overcome barriers and challenges

“…In this issue of the journal, Kumagai et al . report on the first survey of pediatric gastroenterologists in Japan to explore their perceptions of transitional care and to allow comparison of the views of the two sets of specialists 4 . These results revealed that the general views of pediatric and adult gastroenterologists regarding transitional care for IBD were similar except for the appropriate timing of the transfer 4 .…”

“…report on the first survey of pediatric gastroenterologists in Japan to explore their perceptions of transitional care and to allow comparison of the views of the two sets of specialists 4 . These results revealed that the general views of pediatric and adult gastroenterologists regarding transitional care for IBD were similar except for the appropriate timing of the transfer 4 . Three‐quarters of the pediatric gastroenterologists considered that a patient age of 18–22 years was ideal; 4 on the other hand, two‐thirds of the adult gastroenterologists considered that the ideal patient age for transfer was 16 years 3 .…”

Transitional Care for Patients with Inflammatory Bowel Disease: Japanese Experience

“…The abovementioned Japanese survey indicated that adult gastroenterologists considered an age of 16 years to be reasonable to transfer point [16]. However, another Japanese survey of pediatric gastroenterologists revealed some discrepancy in their views regarding the timing of transfer in comparison to adult gastroenterologists: the majority of the former considered an age of 18 years or above to be ideal [29]. Both surveys showed that complex issues, such as psychological immaturity and autism spectrum disorders, presented a considerable barrier to successful patient transition and might necessitate some delay before transfer.…”

“…On official transfer from a pediatric to an adult gastroenterologist, proper provision of the patient’s medical record to the latter was one of the most important points highlighted by the abovementioned Japanese surveys [16, 29]. JSPGHAN has presented a standardized template for the medical record which is also designed to allow the patient to be able to manage alone [14].…”

“…Poor coordination between pediatric and care providers and provision of an inadequate medical summary are known to be barriers to smooth transition [16, 29]. Therefore, provision of a proper medical record documented by a pediatric gastroenterologist is essential.…”