Long-term implications of structured transition of adolescents with inflammatory bowel disease into adult health care: a retrospective study.
Adolescent
Adult
Digestive System Surgical Procedures
/ economics
Germany
/ epidemiology
Health Expenditures
/ statistics & numerical data
Hospitalization
/ statistics & numerical data
Humans
Inflammatory Bowel Diseases
/ epidemiology
Male
Outcome and Process Assessment, Health Care
Puberty, Delayed
/ epidemiology
Quality of Life
Socioeconomic Factors
Time
Transition to Adult Care
/ economics
Epidemiology
Paediatrics
Quality of life
Socio-economical and psychological end points
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
19 Jul 2019
19 Jul 2019
Historique:
received:
10
07
2019
accepted:
15
07
2019
entrez:
21
7
2019
pubmed:
22
7
2019
medline:
25
1
2020
Statut:
epublish
Résumé
We aimed to evaluate the long-term clinical and socioeconomic outcome of structured transition care in adolescents with inflammatory bowel disease (IBD). We compared the clinical long-term course of 24 patients with and 11 patients without structured transition care within 24 months before and 24 months after transfer from paediatric to adult health care. Socio-economic parameters and quality of life were assessed by IBD Questionnaire (IBDQ-32) and additional items. Treatment costs were calculated for medication, surgery and hospitalisation. The percentage of transfer group patients with an IBD-related intestinal complication was higher compared to the transition group (64% vs. 21%, p = 0.022). We also found a tendency towards a higher number of IBD-related surgery in the transfer group compared to the transition group (46% vs. 13%, p = 0.077). Transfer group patients received higher mean cumulated doses of radiation compared with the transition group (4.2 ± 5.3 mSv vs. 0.01 ± 0.01 mSv, p = 0.036). Delayed puberty was only noted in the transfer group (27%, p = 0.025). Mean expenditures for surgeries and hospitalisation tended to be lower in the transition group compared to transfer group patients (744 ± 630€ vs. 2,691 ± 4,150€, p = 0.050). Sexual life satisfaction was significantly higher (p = 0.023) and rates of loose bowel movements tended to be lower (p = 0.053) in the transition group. Structured transition of adolescents with IBD from paediatric into adult health care can lead to important clinical and economic benefits.
Sections du résumé
BACKGROUND
BACKGROUND
We aimed to evaluate the long-term clinical and socioeconomic outcome of structured transition care in adolescents with inflammatory bowel disease (IBD).
METHODS
METHODS
We compared the clinical long-term course of 24 patients with and 11 patients without structured transition care within 24 months before and 24 months after transfer from paediatric to adult health care. Socio-economic parameters and quality of life were assessed by IBD Questionnaire (IBDQ-32) and additional items. Treatment costs were calculated for medication, surgery and hospitalisation.
RESULTS
RESULTS
The percentage of transfer group patients with an IBD-related intestinal complication was higher compared to the transition group (64% vs. 21%, p = 0.022). We also found a tendency towards a higher number of IBD-related surgery in the transfer group compared to the transition group (46% vs. 13%, p = 0.077). Transfer group patients received higher mean cumulated doses of radiation compared with the transition group (4.2 ± 5.3 mSv vs. 0.01 ± 0.01 mSv, p = 0.036). Delayed puberty was only noted in the transfer group (27%, p = 0.025). Mean expenditures for surgeries and hospitalisation tended to be lower in the transition group compared to transfer group patients (744 ± 630€ vs. 2,691 ± 4,150€, p = 0.050). Sexual life satisfaction was significantly higher (p = 0.023) and rates of loose bowel movements tended to be lower (p = 0.053) in the transition group.
CONCLUSIONS
CONCLUSIONS
Structured transition of adolescents with IBD from paediatric into adult health care can lead to important clinical and economic benefits.
Identifiants
pubmed: 31324228
doi: 10.1186/s12876-019-1046-5
pii: 10.1186/s12876-019-1046-5
pmc: PMC6642593
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
128Références
Eff Clin Pract. 2001 Nov-Dec;4(6):256-62
pubmed: 11769298
J Pediatr Gastroenterol Nutr. 2002 Mar;34(3):245-8
pubmed: 11964946
Aliment Pharmacol Ther. 2002 Sep;16(9):1603-9
pubmed: 12197839
Gut. 2004 Nov;53(11):1639-45
pubmed: 15479685
Inflamm Bowel Dis. 2005 Feb;11(2):171-7
pubmed: 15677911
BMJ. 2005 Jul 9;331(7508):77
pubmed: 15987704
Gastroenterology. 2006 Mar;130(3):650-6
pubmed: 16530505
Psychother Psychosom Med Psychol. 2006 Jul;56(7):291-8
pubmed: 16715461
Pediatrics. 2006 Jul;118(1):124-9
pubmed: 16818557
J Pediatr Surg. 2007 Feb;42(2):296-9
pubmed: 17270538
Semin Roentgenol. 2007 Oct;42(4):280-6
pubmed: 17919530
Arch Dis Child. 2008 Feb;93(2):160-3
pubmed: 17942588
Ther Umsch. 2007 Aug;64(8):457-62
pubmed: 17988000
Gastroenterol Clin Biol. 2008 May;32(5 Pt 1):451-9
pubmed: 18472377
Gastroenterology. 1991 Nov;101(5):1307-13
pubmed: 1936801
Inflamm Bowel Dis. 2010 Apr;16(4):657-63
pubmed: 19714755
World J Gastroenterol. 2009 Sep 14;15(34):4234-9
pubmed: 19750566
Inflamm Bowel Dis. 2010 Jun;16(6):947-52
pubmed: 19834978
Adv Ther. 2009 Oct;26(10):936-46
pubmed: 19838649
Inflamm Bowel Dis. 2011 Jan;17(1):423-39
pubmed: 20564651
Aliment Pharmacol Ther. 2010 Dec;32(11-12):1357-63
pubmed: 21050238
Inflamm Bowel Dis. 2011 Jun;17(6):1314-21
pubmed: 21560194
Pediatrics. 2011 Jul;128(1):182-200
pubmed: 21708806
Pediatr Surg Int. 2011 Oct;27(10):1063-8
pubmed: 21785979
Z Gastroenterol. 2011 Sep;49(9):1276-341
pubmed: 21866493
Child Care Health Dev. 2011 Nov;37(6):821-32
pubmed: 22007982
Clin Gastroenterol Hepatol. 2012 Mar;10(3):259-65
pubmed: 22083022
J Crohns Colitis. 2011 Dec;5(6):509-19
pubmed: 22115368
Eat Behav. 2012 Aug;13(3):207-13
pubmed: 22664398
Gut. 2013 Mar;62(3):368-75
pubmed: 22717453
Nat Rev Gastroenterol Hepatol. 2012 Sep;9(9):489
pubmed: 22825539
J Crohns Colitis. 2013 Aug;7(7):e241-8
pubmed: 23040290
J Gastroenterol. 2013 Jun;48(6):713-20
pubmed: 23124604
Gut. 2014 Jan;63(1):72-9
pubmed: 23135759
Inflamm Bowel Dis. 2013 Sep;19(10):2098-110
pubmed: 23860567
JAMA Pediatr. 2013 Oct;167(10):939-46
pubmed: 23959392
J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):795-806
pubmed: 24231644
Clin Gastroenterol Hepatol. 2014 Dec;12(12):2055-62.e1
pubmed: 24726907
Z Rheumatol. 2014 Aug;73(6):526-31
pubmed: 25037479
Inflamm Bowel Dis. 2014 Nov;20(11):2083-91
pubmed: 25137417
Appetite. 2015 Jan;84:240-50
pubmed: 25312748
Inflamm Bowel Dis. 2015 Jan;21(1):121-31
pubmed: 25437816
Z Gastroenterol. 2014 Dec;52(12):1431-84
pubmed: 25474283
Inflamm Bowel Dis. 2015 Mar;21(3):615-22
pubmed: 25636120
Inflamm Bowel Dis. 2015 Jul;21(7):1641-51
pubmed: 25966837
Inflamm Bowel Dis. 2015 Aug;21(8):1794-800
pubmed: 26020601
Gastroenterol Res Pract. 2015;2015:260807
pubmed: 26064089
J Adolesc Health. 2015 Aug;57(2):212-7
pubmed: 26206442
Gastroenterology. 1989 Mar;96(3):804-10
pubmed: 2644154
J Crohns Colitis. 2016 Feb;10(2):216-25
pubmed: 26520163
Patient Educ Couns. 2016 Mar;99(3):421-428
pubmed: 26597543
World J Gastroenterol. 2016 Feb 28;22(8):2611-20
pubmed: 26937149
J Crohns Colitis. 2016 Oct;10(10):1144-50
pubmed: 26995185
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):939-942
pubmed: 27602705
J Pediatr Gastroenterol Nutr. 2017 Jan;64(1):47-55
pubmed: 27657882
Clin Gastroenterol Hepatol. 2017 Apr;15(4):518-524
pubmed: 27717842
J Pediatr Gastroenterol Nutr. 2017 Aug;65(2):200-206
pubmed: 27801751
Aliment Pharmacol Ther. 2017 Jan;45(1):3-13
pubmed: 27862107
Eur J Gastroenterol Hepatol. 2017 Aug;29(8):926-931
pubmed: 28471820
Dtsch Arztebl Int. 2017 May 12;114(19):331-338
pubmed: 28597827
Inflamm Bowel Dis. 2017 Sep;23(9):1483-1491
pubmed: 28816756
United European Gastroenterol J. 2018 Mar;6(2):310-321
pubmed: 29511561
J Pediatr Gastroenterol Nutr. 1993 May;16(4):373-80
pubmed: 8315544
Eur J Gastroenterol Hepatol. 1995 Nov;7(11):1043-50
pubmed: 8680903