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Can a transition clinic bridge the gap between paediatric and adult inflammatory bowel disease care models?
Olga Maria Nardone1, Marietta Iacucci2, Subrata Ghosh2
1Institute of Translational Medicine and Institute of Immunology and Immunotherapy, University of Birmingham, UK; Gastroenterology, Department of Clinical Medicine and Surgery University Federico II of Naples, Italy.
Insights
Transitioning pediatric inflammatory bowel disease (IBD) patients to adult care requires a tailored approach. Implementing a transition clinic and a "treat to target" strategy can improve outcomes for young adults with IBD.
Area of Science:
- Gastroenterology
- Pediatric Healthcare
- Transition Medicine
Background:
- Transition care for pediatric inflammatory bowel disease (IBD) patients presents unique challenges due to differing healthcare models and disease management strategies.
- The transition process involves moving adolescents and young adults from pediatric to adult healthcare settings, necessitating a flexible, individualized approach.
Purpose of the Study:
- To enhance the management of inflammatory bowel disease (IBD) transition care by addressing the gap between pediatric and adult healthcare.
- To propose an updated transition clinic model and a "treat to target" approach to facilitate successful patient transition.
Main Methods:
- Review and update of existing transition clinic models for inflammatory bowel disease (IBD).
- Proposal of a "treat to target" strategy tailored to the clinical, psycho-social, and educational needs of adolescents and young adults.
Main Results:
- The study highlights the critical need for structured transition programs in IBD care.
- A "treat to target" approach is suggested to optimize treatment efficacy and monitoring during the transition phase.
Conclusions:
- Transition clinics are essential for the growing population of pediatric IBD patients requiring lifelong care.
- Further research is needed to define the role of transition clinics and biomarker-guided "treat to target" strategies in optimizing IBD management.
Abstract:
Transition care in inflammatory bowel disease is increasingly recognized as challenging given the inherent differences between paediatric and adult health care models, disease characteristics and treatment strategies. Transition is a dynamic process involving adolescents and young adults that are moving from a paediatric to an adult health care setting, and it should be flexible, continually updated and tailored to each patient. The implementation of a transition clinic is essential given the increasing incidence of the paediatric population with inflammatory bowel disease and the lifelong impact of this disease. The key question is when and how to structure transition according to the adolescent's clinical, psycho-social, educational needs and expectations to ensure continuity of care. In the attempt to improve the management of transition in inflammatory bowel disease and address the wide gap between adult and child care, we provide an update of the transition clinic and we propose a "treat to target" approach in transition to facilitate an effective and successful transition programme. In the changing landscape of the treatment of inflammatory bowel disease, further studies are necessary to determine the role of the transition clinic in determining the choice and strategy of therapy and its monitoring and the adoption of newer strategies such as biomarkers guided treating to target.
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