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Moving On: Transition Readiness in Adolescents and Young Adults With IBD
Amitha Prasad Gumidyala1, Rachel N Greenley2, Jill M Plevinsky2
1Denver VA Medical Center, Eastern Colorado Health Care System, Denver, CO.
Insights
Adolescents and young adults with inflammatory bowel diseases (IBD) need better support for healthcare transition. Improved patient-provider communication and older age are key to readiness for managing IBD independently.
Area of Science:
- Pediatric gastroenterology
- Adolescent health
- Transition of care
Background:
- Inflammatory bowel diseases (IBD) frequently manifest in adolescents and young adults (AYA).
- Successful transition from pediatric to adult healthcare requires AYA to develop self-care, decision-making, and self-advocacy skills.
- Empirical research on factors influencing transition readiness in AYA with IBD is limited.
Purpose of the Study:
- To describe transition readiness in AYA with IBD.
- To identify modifiable and nonmodifiable factors associated with transition readiness.
Main Methods:
- Seventy-five AYA (ages 16-20) and their parents participated.
- Data collected included demographics, patient-provider communication, transition readiness, and AYA disease self-efficacy.
- Disease information was abstracted from medical records.
Main Results:
- Deficits were observed in AYA knowledge of insurance, appointment scheduling, and medication refills.
- Older AYA age, higher self-efficacy, and increased patient-provider communication correlated with better transition readiness and responsibility.
- Regression analysis identified older age and communication as key predictors of AYA responsibility and readiness.
Conclusions:
- AYA with IBD exhibit deficits in disease management responsibility, impacting self-management skills.
- Provider communication is crucial for enhancing transition readiness.
- Delaying transition to allow more time for skill mastery may be beneficial.
Background:
Inflammatory bowel diseases (IBD) often begins early in life. Adolescents and young adults (AYA) with IBD have to acquire behaviors that support self-care, effective healthcare decision-making, and self-advocacy to successfully transition from pediatric to adult health care. Despite the importance of this critical time period, limited empirical study of factors associated with transition readiness in AYA exists. This study aimed to describe transition readiness in a sample of AYA with IBD and identify associated modifiable and nonmodifiable factors.
Methods:
Seventy-five AYA (ages 16-20) and their parents participated. AYA and parents reported on demographics, patient-provider transition-related communication, and transition readiness. AYA self-reported on disease self-efficacy. Disease information was abstracted from the medical record.
Results:
Deficits in AYA responsibility were found in knowledge of insurance coverage, scheduling appointments, and ordering medication refills. Older AYA age, higher AYA disease-management self-efficacy, and increased patient-provider transition communication were each associated with higher overall transition readiness and AYA responsibility scores. Regression analyses revealed that older AYA age and increased patient-provider transition-related communication were the most salient predictors of AYA responsibility for disease management and overall transition readiness across parent and AYA reports.
Conclusions:
AYA with IBD show deficits in responsibility for their disease management that have the potential to affect their self-management skills. Findings suggest provider communication is particularly important in promoting transition readiness. Additionally, it may be beneficial to wait to transition patients until they are older to allow them more time to master skills necessary to responsibly manage their own healthcare.
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