Inflammatory Bowel Disease: A Practical Path to Transitioning From Pediatric to Adult Care.

ABSTRACT

The growing need for transitional care is quickly becoming apparent in the medical community because children with chronic illnesses are surviving into adulthood. Transitional care is the coordinated movement of young adults with chronic conditions from the pediatric to adult health care setting. This transition period is associated with poorer health outcomes due to differences in pediatric and adult health care models, reluctance to change providers, and transfer of disease ownership. These factors must be considered in inflammatory bowel disease (IBD), in which 25% of patients are diagnosed before adulthood and there is an increasing incidence in the pediatric population. Additionally, those with childhood IBD tend to have more severe disease, making structured transition programs imperative to ensure continuity of care and promote self-advocacy. Recommended models for transition have been based on descriptive data rather than on prospective or randomized studies, but the recent IBD literature supports a need for transitional care. Regardless, a great deal of variability in clinical practice remains because there is no agreed upon optimal transition model. This review addresses the status of transitional care in IBD and provides helpful resources to assess patient readiness for transition and to assist in the care of the young transitioning adult.