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Benefits of Structured Pediatric to Adult Transition in Inflammatory Bowel Disease: The TRANSIT Observational Study
Sara McCartney1, James O Lindsay2, Richard K Russell3
1University College London Hospitals NHS Foundation Trust.
Insights
Structured transition from pediatric to adult inflammatory bowel disease (IBD) care improves patient outcomes, reducing flares and hospital admissions. This approach is cost-neutral, benefiting young IBD patients transitioning to adult services.
Area of Science:
- Gastroenterology
- Pediatric care
- Healthcare management
Background:
- Transitioning pediatric patients with inflammatory bowel disease (IBD) to adult care presents challenges.
- Optimizing this transition is crucial for maintaining patient health and managing healthcare resources effectively.
Purpose of the Study:
- To assess the impact of a structured transition program from pediatric to adult IBD services.
- To evaluate objective patient outcomes, including disease flares, hospital admissions, and healthcare utilization.
Main Methods:
- A retrospective observational study was conducted across 11 UK gastroenterology centers.
- Compared outcomes for 95 transition patients (joint pediatric-adult visits) and 34 non-transition patients over 12 months pre- and post-transition.
- Data collected from medical records.
Main Results:
- Transition patients experienced fewer disease flares (P=0.05) and were more likely to be steroid-free (71% vs 41%, P<0.05).
- Emergency department visits leading to hospital admission were lower in the transition group (5% vs 18%, P<0.05).
- Mean annual healthcare costs were comparable (£1644.22 vs £1827.32, P=0.21).
Conclusions:
- Structured transition to adult IBD care is associated with improved clinical outcomes for pediatric patients.
- The structured approach demonstrates positive impacts on disease management without increasing healthcare costs.
Objective:
To evaluate the impact of structured transition from pediatric to adult inflammatory bowel disease (IBD) services on objective patient outcomes, including disease flares, admission rates, and healthcare resource use.
Methods:
A retrospective observational study in 11 United Kingdom gastroenterology centers. Transition patients attended ≥2 visits to the gastroenterology service with both pediatric and adult personnel jointly present; non-transition patients transferred to adult services without joint visits. Data were collected from medical records for the 12-month periods before and after the date of the first visit involving adult IBD services (index visit).
Results:
A total of 129 patients were included: 95 transition patients and 34 non-transition patients. In the 12 months post-index visit, transition patients had fewer disease flares (P = 0.05), were more likely to be steroid-free (71% vs 41%, P < 0.05), and were less likely to have an emergency department visit leading to hospital admission (5% vs 18%, P < 0.05). During this period, the mean estimated overall cost of care per patient was £1644.22 in the transition group and £1827.32 in the non-transition group (P = 0.21).
Conclusion:
Structured transition from pediatric to adult IBD care services was associated with positive and cost-neutral outcomes in patients with pediatric IBD.
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