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Navigating the transition: a multidisciplinary approach to inflammatory bowel disease in children
A Raffaele1,2, C M Ferlini2, G Fusi2
1Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, Pavia, Italy.
Insights
A multidisciplinary approach improves outcomes for pediatric Inflammatory Bowel Disease (IBD) patients, reducing dropout rates and aiding transition to adult care. This strategy shows effectiveness in achieving clinical remission and minimizing treatment attrition.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Clinical Research
Background:
- Inflammatory Bowel Disease (IBD) management in pediatric patients requires specialized care.
- A multidisciplinary approach has shown promise in improving outcomes and facilitating care transitions.
- Transitioning from pediatric to adult IBD care presents unique challenges.
Purpose of the Study:
- To evaluate the impact of a multidisciplinary approach on disease activity in pediatric IBD patients.
- To assess the influence of this approach on patient dropout rates during the transition period.
- To analyze how the multidisciplinary strategy affects the overall transition process to adult care.
Main Methods:
- Longitudinal observational study design.
- Inclusion of pediatric-adolescent IBD patients with a minimum 12-month follow-up.
- Endpoint assessment included therapeutic strategies, surgical intervention needs, and transition characteristics.
Main Results:
- 19 patients included: 13 Ulcerative Colitis (UC), 6 Crohn's disease (CD).
- Over 50% in both groups received biologics; good compliance observed with low dropout rates (5-10%).
- Crohn's disease patients had a significantly higher need for surgery (16% vs. 7.7%, p<0.01).
Conclusions:
- The multidisciplinary approach is effective for IBD transition-age patients.
- This strategy shows potential in achieving clinical remission.
- The approach may significantly reduce therapeutic dropouts in IBD management.
Purpose:
A multidisciplinary approach to Inflammatory Bowel Disease (IBD) has recently demonstrated a positive impact in pediatric patients, reducing dropout rates and facilitating the transition to adult care. Our study aims to evaluate how this approach influences disease activity, dropout rates, and transition.
Methods:
We conducted a longitudinal observational study including all patients diagnosed with IBD during pediatric-adolescent age, with a minimum follow-up period of 12 months. For each patient, endpoints included therapeutic approach, need for surgery and transition features.
Results:
We included 19 patients: 13 with Ulcerative Colitis (UC) and 6 with Crohn's disease (CD). Most patients required multiple lines of therapy, with over 50% in both groups receiving biological drugs. Compliance was good, with a single dropout in each group (10, 5%). The need for surgery was significantly higher in the CD group compared to the UC group (16% vs. 7.7%, p < 0.01). Mean age at transition was significantly higher in the UC group compared to the CD group (19.2 ± 0.7 years SD vs. 18.3 ± 0.6 years SD, p < 0.05).
Conclusions:
In our experience, the multidisciplinary approach to IBD in transition-age patients appears effective in achieving clinical remission, offering the potential to reduce therapeutic dropouts.
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