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      Transition care in inflammatory bowel disease: A needs assessment survey of Quebec gastroenterologists and allied nurses

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          Abstract

          AIM

          To determine the tools needed and problems encountered during the transition of inflammatory bowel disease (IBD) patients from pediatric to adult gastroenterologists (GIs) in Québec, Canada.

          METHODS

          We conducted a needs assessment survey of Quebec health care professionals (HCPs). The survey was handed out to 136 Québec HCPs at a local conference in 2013. Additionally, it was emailed to any other HCPs in Quebec involved in caring for IBD patients. The completed surveys were compiled to derive descriptive data. Further specific subgroup analysis was then conducted.

          RESULTS

          Among the conference attendees and individuals emailed 77 (28.2%) completed the questionnaire. Respondents included adult GIs (61.3%), pediatric GIs (20.8%) and IBD nurses (18.3%). The majority of respondents believed that a standardized structure is important for a successful transition. Adult and pediatric GIs equally felt that patients were inadequately prepared for the transition ( P = 0.6). There were significant differences between adult and pediatric GIs when it came to resource availability (55.6% vs 90.9%, P = 0.002) and perceived need of a formal transition clinic (21.7% vs 68.8%, P = 0.0006). Both transition program and medical summaries were identified as the most valuable tools to improve transition.

          CONCLUSION

          As described in previous studies, our survey reinforces the importance of a transition program, education for young adult IBD patients and the need to improve communication between adult and pediatric GIs.

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          Most cited references18

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          Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine.

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            A transition care programme which improves diabetes control and reduces hospital admission rates in young adults with Type 1 diabetes aged 15-25 years.

            To determine if a transition support programme for young adults with diabetes could maintain attendance at a specialist clinic, improve diabetes control and reduce acute hospital admissions with diabetic ketoacidosis (DKA) in 15-25-year-olds with Type 1 diabetes. A transition coordinator/diabetes educator arranged booking and rebooking of appointments for a young adult diabetes clinic based in an adult hospital between July 2001 and March 2006. An after-hours phone support service was initiated. Data collected included source of referral, frequency of clinic attendance and HbA1c at each visit. Numbers of admissions and readmissions with DKA, length of stay and HbA1c on admission were recorded. One hundred and ninety-one young adults were referred. HbA1c at initial referral was 9.3 +/- 2.17%. HbA1c significantly improved to 8.8 +/- 1.9% (P 11% (-2.5 +/- 2.3%, P < 0.001). Eighty-two percent had attended appointments in the last 6 months. There was a significant reduction in DKA admissions falling by 1/3 (P = 0.05), and in readmissions a significant reduction in length of stay (-3.6 days, P = 0.02), over 3.5 years. If young adults are appropriately supported in adult services, clinic attendance is maintained, diabetes control is improved and hospital admission rates with DKA are reduced. The cost savings from reduced admissions covered the costs of the programme.
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              Inflammatory bowel disease: the difference between children and adults.

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                Author and article information

                Journal
                World J Gastrointest Pharmacol Ther
                WJGPT
                World Journal of Gastrointestinal Pharmacology and Therapeutics
                Baishideng Publishing Group Inc
                2150-5349
                6 August 2017
                6 August 2017
                : 8
                : 3
                : 186-192
                Affiliations
                Matthew Strohl, Department of Internal Medicine, McGill University Health Center, Montreal, QC H4A 3J1, Canada
                Xun Zhang, Research Institute, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
                Dominique Lévesque, Department of Pediatric Gastroenterology, McGill University Health Center, Montreal, QC H4A 3J1, Canada
                Talat Bessissow, Department of Gastroenterology, Montreal General Hospital C7-200, McGill University Health Center, Montreal, QC H4A 3J1, Canada
                Author notes

                Author contributions: Strohl M initially compiled all the data from completed surveys, partook in statistical analysis and interpretation of data; additionally, wrote draft and was the first author of manuscript; Zhang X was responsible for statistical analysis of the manuscript and deriving summary descriptive data; Lévesque D conceived the idea of the survey, took part in designing the survey and assisted in draft revision and editing; Bessissow T was a major contributor to multiple revisions and edits and assisted significantly with fine-tuning the final draft.

                Correspondence to: Dr. Talat Bessissow, Division of Gastroenterology, Montreal General Hospital C7-200, McGill University Health Center, 1650 Avenue Cedar, Montreal, QC H4A 3J1, Canada. talat.bessissow@ 123456mcgill.ca

                Telephone: +1-514-9348531 Fax: +1-514-9348531

                Article
                jWJGPT.v8.i3.pg186
                10.4292/wjgpt.v8.i3.186
                5547377
                28828197
                156245c2-500e-44cd-b389-bbcd2342ee86
                ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

                Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 17 February 2017
                : 28 March 2017
                : 9 May 2017
                Categories
                Observational Study

                inflammatory bowel disease,transition,paediatric,canada,tools,health care professionals

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