Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation

Sattoe, Jane N. T.; Peeters, Mariëlle A C; Haitsma, Jannie; Staa, AnneLoes van; Wolters, Victorien M.; Escher, Johanna C.

doi:10.1136/bmjopen-2019-033535

Cited by 26 publications

(52 citation statements)

References 41 publications

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“…As for barriers to a seamless transfer/transition, many previous studies have identified similar factors to our results. [12][13][14][15][16] In discussing transitional care, the specific healthcare environment or medical resources for pediatric health care must be considered. For instance, the practice setting is a major issue.…”

Section: Discussionmentioning

confidence: 99%

“…Recognition of the roles of these individuals in multidisciplinary care and maximization of communication between them is of strategic importance 17 . For successful transitional care, 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 15 . Although there is no common definition of a transition clinic and the settings are notably heterogeneous, 18 a multidisciplinary approach and good interaction among the various stakeholders are a potential basis for success for transition 16 .…”

Section: Discussionmentioning

confidence: 99%

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

Kumagai¹,

Kudo²,

Uchida³

et al. 2021

Pediatrics International

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Kumagai¹,

Kudo²,

Uchida³

et al. 2021

Pediatrics International

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“…Currently, however, outpatient transition clinics exist for patients with inflammatory bowel disease, but are lacking for patients with functional gastrointestinal disorders, including constipation. 47…”

Section: Pediatric Chronic Constipation and Transition To Adult Medical Carementioning

confidence: 99%

Chronic constipation in adults: Contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation

Scott

Simrén

Farmer

et al. 2020

Neurogastroenterology Motil

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BACKGROUND: Chronic constipation is a prevalent disorder that affects patients' quality of life and consumes resources in healthcare systems worldwide. In clinical practice, it is still considered a challenge as clinicians frequently are unsure as to which treatments to use and when. Over a decade ago, a Neurogastroenterology & Motility journal supplement devoted to the investigation and management of constipation was published Listen to the podcast for this article 2 of 21 | SCOTT eT al. | INTRODUC TI ONChronic constipation (CC) remains a clinical challenge, with frequent suboptimal outcomes to a variety of conservative, behavioral, medical, and surgical interventions. Over a decade ago, a Neurogastroenterology & Motility journal supplement was devoted to the investigation and management of constipation (2009:21 [Suppl. 2]). This included seven articles, 1-7 disseminating all themes covered during a preceding 2-day meeting held in London, entitled "Current perspectives in chronic constipation: a scientific and clinical symposium." In October 2018, the 3rd London Masterclass, entitled "Contemporary management of constipation" was held, again over 2 days, and again boasting a world-renowned faculty. By way of dissemination, two side-by-side review articles have been produced that represent a collective synthesis of talks presented and discussions held during this meeting. Authorship includes all invited faculty members. These reviews provide not only an update on topics addressed in the previous journal supplement, but also a stateof-the-art overview of the clinical management of constipation. Areas for future research are additionally highlighted. The first of these reviews addresses epidemiology, diagnosis, clinical associations, pathophysiology, and investigation. Clearly, not all aspects of the condition can be covered in adequate detail; hence, there is a focus on particular "hot topics" and themes that are of contemporary interest. The second, "sister" review, addresses management of chronic constipation, encompassing behavioral, conservative, medical, and surgical therapies. | EPIDEMI OLOGY AND D IAG NOS IS | DefinitionsConstipation is most simplistically defined as unsatisfactory defecation resulting from infrequent stools, difficult stool passage, or both. 8 Alternatively, it is a term that embraces a (limited) spectrum of symptoms related to an individuals' personal dissatisfaction with their evacuatory ability. 4 Symptoms include, though are not restricted to, hard stools, excessive straining, infrequent bowel movements, bloating, and abdominal pain, 9 and if such symptoms last >1 month, constipation is labeled as chronic. CC can be viewed as an umbrella term encompassing all disorders and conditions with long-standing constipation, and can be primary or secondary. Multiple conditions may cause secondary CC, for example, drugs (opioids, calcium channel blockers, NSAIDs), neurological disorders (Parkinson's disease), or metabolic diseases (diabetes). 10 Primary CC (which is the main focus of these review...

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“…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.…”

Section: Barriers To Successful Transitionmentioning

confidence: 99%

“…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].…”

Section: Joint Clinic and Alternative Visitmentioning

confidence: 99%

Transitional Care for Patients with Inflammatory Bowel Disease: Japanese Experience

2020

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Background: Transition-related healthcare intervention has recently been receiving worldwide attention. Given the increasing incidence of pediatric inflammatory bowel disease (IBD) and its lifelong impact, transitional care has become an important issue. In Japan, guidelines to support the autonomy of IBD patients during transition were recently published. Summary: Here, we review current issues regarding care for IBD patients during transition from the pediatric to adult period in order to identify the barriers and key elements for successful transition in the context of the Japanese system. Although no single optimal model of transitional care exists, crucial elements identified so far include a joint pediatric/adult clinic or alternating visits between pediatric and adult healthcare providers, a multidisciplinary approach, and good coordination among stakeholders. Self-reliance and independence of patients with childhood-onset IBD are also considered essential for successful transition. Various tools for assessment of transition readiness have been validated and are considered useful. Better outcomes are expected for individually tailored transition, including improvements in medication adherence, perceived health status, quality of life, and self-management. The timing of transfer from a pediatric to an adult gastroenterologist should not be fixed because the issue is not chronological age but rather the degree of individual maturity. We also propose a standardized medical summary with a checklist template for official referral of patients from a pediatric to an adult gastroenterologist. Key Messages: Transition programs require a multidisciplinary approach with a coordinator (IBD nurse) and optimal collaboration and communication. Lack of resources and funding are also pertinent issues.

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Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation

Cited by 26 publications

References 41 publications

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

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

Chronic constipation in adults: Contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation

Transitional Care for Patients with Inflammatory Bowel Disease: Japanese Experience

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