A Personalized eHealth Transition Concept for Adolescents With Inflammatory Bowel Disease: Design of Intervention.

adolescents adult care inflammatory bowel disease transfer transition

Journal

JMIR pediatrics and parenting
ISSN: 2561-6722
Titre abrégé: JMIR Pediatr Parent
Pays: Canada
ID NLM: 101727244

Informations de publication

Date de publication:
24 Apr 2019
Historique:
received: 19 09 2018
accepted: 24 03 2019
revised: 27 02 2019
entrez: 14 9 2019
pubmed: 14 9 2019
medline: 14 9 2019
Statut: epublish

Résumé

Transfer from pediatric to adult care is a crucial period for adolescents with inflammatory bowel disease (IBD). Our aim was to develop a personalized transition-transfer concept including relevant tools in an established eHealth (electronic health) program. Required transition skills and validated patient-reported outcome measures (PROMs) were identified via bibliographic search and clinical experience and were implemented into an existing eHealth program. The following skills were identified: disease knowledge, social life, disease management, and making well-informed, health-related decisions. The PROMs included the following: self-efficacy (the IBD Self-Efficacy Scale-Adolescents), resilience (the 10-item Connor-Davidson Resilience Scale), response to stress (the Child Self-Report Responses to Stress-IBD), and self-management and health care transition skills (the Self-Management and Transition to Adulthood with Treatment questionnaire). Starting at age 14, the patient will be offered a 1-hour annual transition consultation with an IBD-specialized nurse. The consultation will be based on the results of the PROMs and will focus on the patient's difficulties. Patients will complete the PROMs on the eHealth program at home, allowing nurses and patients to prepare for the meeting. Symptom scores and medication will be filled out on the eHealth program to support disease self-management. The consultation will be a topic-centered dialogue with practical exercises. During routine outpatient visits with the provider, parents will be left out of half of the consultation when the patient is 16 years old; at 17 years old, the parents will not be present. At the transfer consultation, the pediatric provider, the adult gastroenterologist, the pediatric nurse, the patient, and the parents will be present to ensure a proper transfer. We have conducted a personalized eHealth transition concept consisting of basic elements that measure, train, and monitor the patients' transition readiness. The concept can be implemented and adjusted to local conditions.

Sections du résumé

BACKGROUND BACKGROUND
Transfer from pediatric to adult care is a crucial period for adolescents with inflammatory bowel disease (IBD).
OBJECTIVE OBJECTIVE
Our aim was to develop a personalized transition-transfer concept including relevant tools in an established eHealth (electronic health) program.
METHODS METHODS
Required transition skills and validated patient-reported outcome measures (PROMs) were identified via bibliographic search and clinical experience and were implemented into an existing eHealth program.
RESULTS RESULTS
The following skills were identified: disease knowledge, social life, disease management, and making well-informed, health-related decisions. The PROMs included the following: self-efficacy (the IBD Self-Efficacy Scale-Adolescents), resilience (the 10-item Connor-Davidson Resilience Scale), response to stress (the Child Self-Report Responses to Stress-IBD), and self-management and health care transition skills (the Self-Management and Transition to Adulthood with Treatment questionnaire). Starting at age 14, the patient will be offered a 1-hour annual transition consultation with an IBD-specialized nurse. The consultation will be based on the results of the PROMs and will focus on the patient's difficulties. Patients will complete the PROMs on the eHealth program at home, allowing nurses and patients to prepare for the meeting. Symptom scores and medication will be filled out on the eHealth program to support disease self-management. The consultation will be a topic-centered dialogue with practical exercises. During routine outpatient visits with the provider, parents will be left out of half of the consultation when the patient is 16 years old; at 17 years old, the parents will not be present. At the transfer consultation, the pediatric provider, the adult gastroenterologist, the pediatric nurse, the patient, and the parents will be present to ensure a proper transfer.
CONCLUSIONS CONCLUSIONS
We have conducted a personalized eHealth transition concept consisting of basic elements that measure, train, and monitor the patients' transition readiness. The concept can be implemented and adjusted to local conditions.

Identifiants

pubmed: 31518331
pii: v2i1e12258
doi: 10.2196/12258
pmc: PMC6715343
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e12258

Informations de copyright

©Katrine Carlsen, Mette Hald, Marla C Dubinsky, Laurie Keefer, Vibeke Wewer. Originally published in JMIR Pediatrics and Parenting (http://pediatrics.jmir.org), 24.04.2019.

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Auteurs

Katrine Carlsen (K)

Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark.

Mette Hald (M)

Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark.

Marla C Dubinsky (MC)

Division of Pediatric Gastroenterology and Hepatology, Susan and Leonard Feinstein IBD Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States.

Laurie Keefer (L)

Division of Gastroenterology, Susan and Leonard Feinstein IBD Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States.

Vibeke Wewer (V)

Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark.

Classifications MeSH