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  • Review Article
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Transition of management in adolescents with IBD

Nature Reviews Gastroenterology & Hepatology volume 11, pages 109–115 (2014)Cite this article

Subjects

Key Points

  • Transition of care is a gradual process in which adolescents learn to assume personal responsibility for their health care, culminating in transfer of care from a paediatric to adult-based model

  • Transition of care will usually begin early in adolescence (age 10–12 years), with final transfer of care occurring most often between 18 and 23 years, although exceptions exist

  • Major barriers to successful transition of care include psychological factors, deficits in self-management skills and system-based factors

  • Failure to successfully transition could lead to compromised emotional and physical health outcomes

  • Structured transitional care programmes facilitate the shift of responsibility from parent to patient, create pathways to transfer records from paediatric to adult providers, and help patients and families navigate access to care

  • Benefits of transitional care tools and initiatives are supported by expert consensus and by studies investigating subjective patient satisfaction-based outcome measurements, but their influence on objective health outcomes warrants further study

Abstract

Transfer of care is when a patient and his or her medical records move from one provider to another at a distinct point in time. By contrast, transition of care is a gradual process of change in knowledge, attitudes and behaviour through which the adolescent can learn to assume personal responsibility for his or her health care. IBD is a prevalent disorder, often diagnosed during childhood. Because mortality of this condition is fortunately low, children diagnosed with IBD will, at some point, transition from a paediatric to adult health-care model. Paediatric and adult health-care paradigms, including IBD-specific care, are different in a number of key areas and it is becoming increasingly apparent that young adults with chronic illness often face challenging transitions, resulting in compromised physical and emotional health outcomes. In the past decade, refining the processes related to transition of care for adolescents with chronic medical conditions has gained traction as an important public health initiative. The aim of this paper is to review concepts pertinent to transition of management for adolescents and young adults with IBD, and to review the current literature and evidence supporting transitional care in paediatric IBD.

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Authors and Affiliations

  1. Division of Digestive Diseases, Hepatology & Nutrition, Connecticut Children's Medical Center, 282 Washington Street, Hartford, 06106, CT, USA

    Bella Zeisler & Jeffrey S. Hyams

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  1. Bella Zeisler
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Both authors contributed equally to all aspects of this manuscript.

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Correspondence to Jeffrey S. Hyams.

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The authors declare no competing financial interests.

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Zeisler, B., Hyams, J. Transition of management in adolescents with IBD. Nat Rev Gastroenterol Hepatol 11, 109–115 (2014). https://doi.org/10.1038/nrgastro.2013.254

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