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Shapiro JM, El-Serag HB, Gandle C, Peacock C, Denson LA, Fishman LN, Hernaez R, Hou JK. Recommendations for Successful Transition of Adolescents With Inflammatory Bowel Diseases to Adult Care. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2020 Feb 1; 18(2):276-289.e2.
Abstract: Adolescents and young adults diagnosed with inflammatory bowel diseases (IBDs) in pediatric care are vulnerable during their transition to adult care. There are 6 core elements of transition from pediatric to adult IBD care. We identified gaps in this transition and make recommendations for clinical practice and research. There have been few studies of transition policy (core element 1) or studies that tracked and monitored patients through the transition (core element 2). Several studies have assessed transition readiness (core element 3), but instruments for assessment were not validated using important outcomes such as disease control, health care use, adherence, quality of life, or continuity of care. There have been no studies of best practices for transition planning (core element 4), including how to best educate patients and facilitate gradual shifts in responsibility. A small number of longitudinal studies have investigated transfer of care (core element 5), but these were conducted outside of the United States; these studies found mixed results in short- and intermediate-term outcomes after transition completion (core element 6). We discuss what is known about the transition from pediatric to adult care for IBD, make recommendations to improve this process, and identify areas for additional research.