Abstract
To reduce lapses in care for pediatric inflammatory bowel disease (IBD) patients approaching adulthood, a health maintenance transition visit (HMV) was developed to supplement standard medical care (SMV). Our aim was to assess the effect of the HMV on transition readiness. A retrospective chart review was conducted at a single center with demographics and clinical data from HMV and SMV visits. Effectiveness of the HMV was assessed by the patient health questionanaire-9 (PHQ-9) and transition readiness assessment questionnaire (TRAQ) scores. A total of 140 patients, 80% Caucasian and 59% male completed an HMV. The mean age was 18 ± 2 years old, and 93% of patients reported inactive or mild disease. Patients who completed at least 1 prior HMV scored significantly higher on the TRAQ when transferring to adult care compared to patients transferred at their first HMV visit (92 vs. 83, p < 0.05). Of patients with no prior depression diagnosis, 36% had a positive screen for depression. A significant relationship was identified between disease status and PHQ-9 (p < 0.05). This study demonstrated a structured HMV increased transition readiness and quantified the significant under-diagnosis of depression in this population, emphasizing the importance of screening. These results indicate depression may affect patients’ transition preparedness.
Highlights
The incidence of pediatric-onset inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis (UC), is rising worldwide [1,2]
A total of 140 patients who completed at least 1 health maintenance visit (HMV) since the transition clinic began in 2014 were included in this study
This study evaluated the clinical application of a specialized multi-disciplinary health maintenance
Summary
The incidence of pediatric-onset inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis (UC), is rising worldwide [1,2]. Pediatric-onset IBD tends to demonstrate both extensive disease and a rapid progression such that patients require early immunomodulating therapy [3]. The impact of IBD on an adolescent patients’ quality of life extends beyond their standard medical care. Adolescent patients with IBD are at an increased risk of depression and poor adherence to treatment plans [4,5,6]. This poor adherence exacerbates disease activity, results in lapses in care, and predisposes patients to preventable complications [7]
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