Assessing the Transition Intervention Needs of Young Adults With Inflammatory Bowel Diseases

Klostermann NR1, McAlpine L, Wine E, Goodman KJ, Kroeker KI. J Pediatr Gastroenterol Nutr. 2017 Jul 27. doi: 10.1097/MPG.0000000000001677. [Epub ahead of print]
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1 Division of Gastroenterology, Department of Medicine; Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, AB, Canada.


OBJECTIVES: The transition of inflammatory bowel disease (IBD) patients from pediatric to adult care can be challenging. Developing an effective transition intervention requires assessing the current transition experience for potential improvements, determining preferred content and format, and assessing patients' transition skills.

METHODS: This mixed-methods study of 20 transitioned IBD patients (ages 17-20 years) utilized semi-structured interviews and validated assessments of self-management/self-advocacy and IBD knowledge. Interviews were analyzed thematically. Assessment scores were compared to published reference data by estimating proportion or mean differences and 95% confidence intervals.

RESULTS: The concept of a transition intervention was well-received by participants. Preferred content centered on medications, disease and what to expect. Preferred ways to acquire knowledge were one-on-one instruction, handouts and websites. Identified themes were: "individualized and multi-faceted," "teach about transition" and "support the shift in responsibility." Among participants, 95% did not achieve 90% mastery of transition skills (0.6% higher [95% CI: -10.7%, 9.5%] than the reference estimate) and the mean knowledge score was 15.15 (3.86 [95% CI: 2.27, 5.45] points higher than the reference estimate).

CONCLUSIONS: We have identified preferred intervention formats and content as well as skill areas to target for improvement. As a result of this work, we will design a website intervention pertaining to identified themes.

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