S0816 Pediatric to Adult IBD Patient Care: A Comparison of Outcomes Between Transitional Clinic Care and Traditional Clinic Care

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic illness that impacts all age groups. For those diagnosed in childhood, transitioning from pediatric to adult IBD providers can be particularly difficult. We developed an IBD "transition clinic" (TC) at our center to help address these challenges. The aim of our study was to compare the health care utilization of patients who did and did not receive care in our IBD TC. METHODS: We performed a retrospective chart review of 18 to 26-year-old patients transitioning at our IBD center between 2017 and 2018. Data collected included demographic variables, IBD type and duration. IBD related health care resource utilization outcomes were also obtained. These include admissions and no-show rates since the start of TC or adult IBD clinic respectively and steroid use during the first two years since the start of these clinics. A chi-square test for categorical variables and student t-test for continuous variables was used for comparing the variables in both of the groups. All analysis was performed in SAS v9.4. RESULTS: We identified 50 IBD patients who were cared for in our TC and 65 who were not. While the patients seen in TC were significantly younger, each cohort had similar sex distribution, disease duration and disease type distribution (Table 1). TC patients demonstrated lower mean hospital admissions, and a trend toward fewer clinic no-shows (P = 0.05) (Table 1). CONCLUSION: We demonstrated that an IBD transition clinic can improve patient outcomes, as individuals receiving care in our TC were less likely to be admitted to the hospital. It is possible that other key outcomes (including disease activity, IBD complications and psychosocial variables) may also be impacted by this service. Thus, larger, objective studies evaluating these issues in TCs are still needed. Ultimately, identifying a more streamlined and structured, yet customizable, approach to the transition process in IBD is warranted.TABLE 1.: Demographic variables and health care utilization outcomes