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improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator

Gray, Wendy N.*,†; Holbrook, Erin; Dykes, Dana‡,§; Morgan, Pamela J.; Saeed, Shehzad A.‡,§; Denson, Lee A.‡,§

Journal of Pediatric Gastroenterology and Nutrition: April 1, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002350
Original Article: Gastroenterology: Inflammatory Bowel Disease: PDF Only
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Objectives: Deficits in the preparation of patients with inflammatory bowel disease (IBD) who are transitioning to adult care are known yet studies presenting outcome data of transition interventions in IBD are lacking. We present data evaluating the impact of a transition coordinator on behavioral and clinical transition outcomes.

Methods: A retrospective chart review identified 135 patients who had met with our transition coordinator and completed the Transition Readiness Assessment Questionnaire before, and 1 year after, the intervention. Changes in transition readiness, self-management skill acquisition, and clinical outcomes (eg, number of patients transferred vs “bounced back” to pediatrics, percentage of patients over age 21, changes in disease remission) were examined and compared with patients who received no intervention.

Results: Intervention participants demonstrated a significant increase in transition readiness, F(1, 134) = 24.34, P < 0.001, and self-management skill acquisition, F(1, 134) = 5.61, P < 0.05. The percentage of patients in remission significantly increased from pre- to postintervention, χ2(134) = 9.03, P < 0.01. There were no significant changes in the comparison population (Ps > 0.05). Following implementation of our programming, the percentage of patients over age 21 decreased by 33.07%.

Conclusions: A 1-time transition coordinator-led intervention improved adolescent transition readiness and acquisition of self-management skills. The proportion of young adult patients retained in pediatric care was reduced. Benefits of hiring a transition coordinator are discussed.

*Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, CA

Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center

Cincinnati Children's Hospital Medical Center, Schubert-Martin Pediatric IBD Center

§University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH.

Address correspondence and reprint requests to Wendy N. Gray, PhD, Department of Pediatric Psychology, Children's Hospital of Orange County, 1120W. La Veta Avenue, Suite 400, Orange, CA 92868 (e-mail: wendy.gray@choc.org).

Received 6 November, 2018

Accepted 19 February, 2019

This work was supported by a grant from the Crohn's and Colitis Foundation (#285083 to W.N.G.) and an internal grant from the Academic and Research Committee of Cincinnati Children's Hospital Medical Center (to L.A.D.).

Conflicts of interest: S.A.S. is a member of the Speaker's Bureau for Abbie, Inc.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,