Concerns, Barriers, and Recommendations to Improve Transition from Pediatric to Adult IBD Care: Perspectives of Patients, Parents, and Health Professionals

Gray WN1, Resmini AR, Baker KD, Holbrook E, Morgan PJ, Ryan J, Saeed SA, Denson LA, Hommel KA. Inflamm Bowel Dis. 2015 May 11. [Epub ahead of print]
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1*Department of Psychology, Auburn University, Auburn, Alabama; †Division of Gastroenterology, Hepatology and Nutrition, Schubert-Martin Pediatric IBD Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; ‡Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and §Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.


BACKGROUND: The current transition literature is a fragmented assortment of studies examining select subsections of transition stakeholders.

METHODS: Adolescent/young adult patients with IBD (40% transferred to adult care), parents, and health providers (53.8% adult providers) participated in 1 of 6 focus group interviews focused on concerns and needs surrounding transition to adult care. Data were analyzed through directed content analysis.

RESULTS: Transition needs/concerns focused on (1) losing relationships with pediatric providers, (2) perceptions of poorer quality care from adult providers, (3) high parent involvement preventing the development of youth self-management skills, and (4) finances and insurance. Suggestions to improve transition to adult care included the following: (1) meeting alone with adolescents during appointments, (2) providing concrete guidance on how/when to transition responsibility, and (3) increasing accountability for adolescents. Recommendations to improve transfer included the following: (1) providing more information about the transfer process and adult providers, (2) obtaining peer support and mentoring, and (3) setting goals and deadlines for transfer.

CONCLUSIONS: Inclusion of several stakeholder groups allowed for the identification of commonalities across groups as well as their unique needs and concerns surrounding transition to adult care. Concerns and recommendations by participants should be targeted in future transition program efforts.

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