Onyi Oligbo - Transition of Care
Inflammatory Bowel Disease (IBD) is a group of disorders characterized by a defective immune response leading to chronic inflammation of the gastrointestinal tract. The two subcategories, Crohn’s disease and Ulcerative Colitis, are based on the distribution of inflammation throughout the gastrointestinal tract. Internationally, about 25% of IBD cases are diagnosed before age 18. Because IBD is a lifelong diagnosis, transferring from pediatric to adult care is a complex process that can lead to treatment interruption and an increased risk of hospitalization. A study by Alsufyani et al. gave adolescent patients with IBD a Transition Readiness Assessment Questionnaire (TRAQ) to self-assess their skills in medication management, appointment follow-up, tracking health issues, establishing patient-provider relationships, and organizing daily activities.
The patients scored moderately high, suggesting high transition readiness. No significant differences were found between the mean scores of male and female patients, other than males scoring higher in the “tracking health issues” component. Interestingly, many studies on other chronic diseases report more transition readiness among female patients. While not addressed in this study, factors that influence transition readiness and should be investigated further include age, socioeconomic status, education, and psychosocial factors. Further studies should also include a follow-up period, allowing for an association between TRAQ scores and long-term disease progression of IBD.
The transition from adolescence to young adulthood is an incredibly formative period in our lives, consisting of new experiences and increased independence. As you can see, healthcare is no exception as patients must begin preparing for their transition into adult healthcare before turning 18, attending college, or entering the workforce. Because transition readiness is impacted by several factors, the transition process for each patient must be individualized. General pediatricians and pediatric subspecialists should continue to collaborate with patients, families, and interprofessional teams to create tailored and measurable goals to optimize transition readiness.
References:
Alsufyani, H. A., Jar, S., Jambi, W. S., Meer, N., Bajunaid, W., Albaradei, H., Alharbi, N. A., Aziz, H., Mosli, M., & Saadah, O. I. (2023). Transition readiness into adult health care in children with inflammatory bowel disease. Cureus. https://doi.org/10.7759/cureus.46825
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