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Transitional care for inflammatory bowel disease: A survey of Japanese pediatric gastroenterologists
Hideki Kumagai1, Takahiro Kudo2, Keiichi Uchida3
1Department of Pediatrics, Jichi Medical University, Shimotsuke City, Tochigi, Japan.
Insights
Pediatric gastroenterologists largely agree with adult specialists on transitional care for pediatric-onset inflammatory bowel disease (IBD), but differ on the ideal transfer age. Preparing tailored transition programs is crucial for effective IBD care.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Healthcare Management
Background:
- Previous research reported adult gastroenterologists' views on transitional care for childhood-onset inflammatory bowel disease (IBD).
- This study surveyed pediatric gastroenterologists to compare their perspectives with adult specialists on IBD transitional care.
Purpose of the Study:
- To compare the views of pediatric and adult gastroenterologists on transitional care for patients with childhood-onset IBD.
- To identify challenges and ideal practices in transitioning IBD patients from pediatric to adult care.
Main Methods:
- A survey was distributed to 48 members of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition.
- Respondents ranked the importance of statements regarding transitional care using a Likert scale.
- The survey achieved a 79% response rate, with 60% of respondents having experience with IBD transitional care.
Main Results:
- 90% of pediatric gastroenterologists viewed transfer to adult care as ideal for adolescents/young adults with IBD.
- 59% reported difficulties in the referral process for transitional care.
- The ideal transfer age was considered to be 18-22 years by most respondents.
- Physicians in municipal hospitals cited comorbidities and staffing shortages as significant challenges.
Conclusions:
- Pediatric and adult gastroenterologists share similar views on IBD transitional care, with notable differences in the preferred age for transfer.
- The findings highlight the necessity of developing practice-specific transition programs for IBD patients.
- Addressing challenges such as staffing and comorbidities is essential for optimizing transitional care.
Background:
In 2019 we reported the results of a Japanese national survey designed to explore the views of adult gastroenterologists regarding transitional care for patients with childhood-onset inflammatory bowel disease (IBD). For the present study, we conducted a similar survey of pediatric gastroenterologists to compare the views of the two sets of specialists.
Methods:
The survey conducted in 2019 involved 48 representative members of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition. They were contacted by conventional mail and their answers were not anonymized. Respondents who had already referred patients with IBD to adult gastroenterologists were asked in a questionnaire to rank the importance of specific statements on a Likert scale.
Results:
The response rate was 79% and 29 (60%) of the respondents had experienced transitional care for patients with IBD. Transfer to adult care was considered by 90% of the respondents to be the ideal form of medical care for adolescents/young adults with IBD. However, 59% of the respondents had experienced some degree of difficulty when making referrals for such care. The majority of pediatric gastroenterologists considered that the ideal age for transfer was 18-22 years. Among the respondents, physicians at municipal hospitals considered that the presence of diseases other than IBD and a shortage of manpower were significantly more important issues than other practice settings.
Conclusions:
The present survey revealed that the general views regarding transitional care for IBD between pediatric and adult gastroenterologists were similar, except for the appropriate time for transfer. The results underline the importance of preparing a transition program appropriate to practice settings.
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