Benefits of Structured Pediatric to Adult Transition in Inflammatory Bowel Disease
Sara McCartney, James O. Lindsay, Richard K. Russell, Daniel R. Gaya, Ian Shaw, Charles Murray, Tricia Finney‐Hayward, Shaji Sebastian
Abstract
ABSTRACT Objective: To evaluate the impact of structured transition from pediatric to adult inflammatory bowel disease (IBD) services on objective patient outcomes, including disease flares, admission rates, and healthcare resource use. Methods: A retrospective observational study in 11 United Kingdom gastroenterology centers. Transition patients attended ≥2 visits to the gastroenterology service with both pediatric and adult personnel jointly present; non‐transition patients transferred to adult services without joint visits. Data were collected from medical records for the 12‐month periods before and after the date of the first visit involving adult IBD services (index visit). Results: A total of 129 patients were included: 95 transition patients and 34 non‐transition patients. In the 12 months post‐index visit, transition patients had fewer disease flares ( P = 0.05), were more likely to be steroid‐free (71% vs 41%, P < 0.05), and were less likely to have an emergency department visit leading to hospital admission (5% vs 18%, P < 0.05). During this period, the mean estimated overall cost of care per patient was £1644.22 in the transition group and £1827.32 in the non‐transition group ( P = 0.21). Conclusion: Structured transition from pediatric to adult IBD care services was associated with positive and cost‐neutral outcomes in patients with pediatric IBD.