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Adolescent transition clinic in inflammatory bowel disease: quantitative assessment of self-efficacy skills

Yerushalmy-Feler, Anata,d,*; Ron, Yuliab,d,*; Barnea, Efratc; Nachum, Ayalac; Matalon, Shayb,d; Dali-levy, Margalita; Dotan, Irisb,d; Cohen, Shlomia,d

European Journal of Gastroenterology & Hepatology: July 2017 - Volume 29 - Issue 7 - p 831–837
doi: 10.1097/MEG.0000000000000864
Original Articles: Inflammatory Bowel Disease

Objectives: There is no model for the process of transition of adolescents with inflammatory bowel diseases (IBD) to the adult care protocol. We recently established a transition clinic where 17-year-old to 18-year-old IBD patients are seen by a multidisciplinary team including pediatric and adult gastroenterologists with expertise in IBD treatments, an IBD nurse, and a psychologist. We quantitatively describe this model and its benefits, and correlate demographic and transition parameters to self-efficacy in IBD adolescent patients before and after transition.

Patients and methods: All adolescent IBD patients enrolled in our transition clinic between January 2013 and December 2015 were included. They completed a self-efficacy questionnaire (‘IBD-yourself’) before and after the transition. The scores were correlated to demographic, disease, and transition parameters.

Results: Thirty of the 36 enrolled patients (mean age: 19±1.8 years, range: 17–27) had Crohn’s disease. Twenty-seven patients completed the transition protocol, which included an average of 3–4 meetings (range: 2–8) over 6.9±3.5 months. Self-efficacy scores in all domains of the questionnaire were significantly higher after completion of the transition. The weighted average score of the questionnaire’s domains was 1.85±0.3 before and 1.41±0.21 after transition (P<0.0001). Age, sex, disease duration, duration of transition, and the number of meetings in the clinic correlated with the questionnaire’s scores in the domains of coping with IBD, knowledge of the transition process, and medication use.

Conclusion: A well-planned adolescent IBD transition clinic contributes significantly toward improved self-efficacy in IBD. We recommend its implementation in IBD centers to enable a personalized transition program tailored to the needs of adolescents with IBD in specific domains.

aPediatric Gastroenterology Unit, ‘Dana-Dwek’ Children’s Hospital

bIBD Center of the Department of Gastroenterology and Liver Diseases

cHealth and Medical Psychological Service

dTel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

* Anat Yerushalmy-Feler and Yulia Ron contributed equally to the writing of this article.

Correspondence to Shlomi Cohen, MD, Pediatric Gastroenterology Unit, ‘Dana-Dwek’ Children’s Hospital, Tel Aviv Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel Tel: +972 369 74515; fax: +972 369 74181; e-mail: shlomico@tlvmc.gov.il

Received October 11, 2016

Accepted February 7, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.