Navigating the transition: a multidisciplinary approach to inflammatory bowel disease in children.
Crohn disease
Dropout
Inflammatory bowel disease
Multidisciplinary approach
Transitional care
Ulcerative colitis
Journal
Pediatric surgery international
ISSN: 1437-9813
Titre abrégé: Pediatr Surg Int
Pays: Germany
ID NLM: 8609169
Informations de publication
Date de publication:
27 Aug 2024
27 Aug 2024
Historique:
accepted:
12
07
2024
medline:
28
8
2024
pubmed:
28
8
2024
entrez:
27
8
2024
Statut:
epublish
Résumé
A multidisciplinary approach to Inflammatory Bowel Disease (IBD) has recently demonstrated a positive impact in pediatric patients, reducing dropout rates and facilitating the transition to adult care. Our study aims to evaluate how this approach influences disease activity, dropout rates, and transition. We conducted a longitudinal observational study including all patients diagnosed with IBD during pediatric-adolescent age, with a minimum follow-up period of 12 months. For each patient, endpoints included therapeutic approach, need for surgery and transition features. We included 19 patients: 13 with Ulcerative Colitis (UC) and 6 with Crohn's disease (CD). Most patients required multiple lines of therapy, with over 50% in both groups receiving biological drugs. Compliance was good, with a single dropout in each group (10, 5%). The need for surgery was significantly higher in the CD group compared to the UC group (16% vs. 7.7%, p < 0.01). Mean age at transition was significantly higher in the UC group compared to the CD group (19.2 ± 0.7 years SD vs. 18.3 ± 0.6 years SD, p < 0.05). In our experience, the multidisciplinary approach to IBD in transition-age patients appears effective in achieving clinical remission, offering the potential to reduce therapeutic dropouts.
Identifiants
pubmed: 39192007
doi: 10.1007/s00383-024-05789-8
pii: 10.1007/s00383-024-05789-8
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
245Informations de copyright
© 2024. The Author(s).
Références
Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP et al (1993) Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolescent Health. https://doi.org/10.1016/1054-139X(93)90143-D
doi: 10.1016/1054-139X(93)90143-D
American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians-American Society of Internal Medicine (2002) A consensus statement on health care transitions for young adults with special health care needs. Pediatrics 110(Supplement 3):1304–1306. https://doi.org/10.1542/peds.110.S3.1304
doi: 10.1542/peds.110.S3.1304
Cooley WC, Sagerman PJ (2011) Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. https://doi.org/10.1542/peds.2011-0969
doi: 10.1542/peds.2011-0969
pubmed: 21987707
Grover Z, De Nardi A, Lewindon PJ (2017) Inflammatory bowel disease in adolescents. Aust Family Phys 46(8):565
Zeisler B, Hyams JS (2014) Transition of management in adolescents with IBD. Nat Rev Gastroenterol Hepatol. https://doi.org/10.1038/nrgastro.2013.254
doi: 10.1038/nrgastro.2013.254
pubmed: 24419396
Menon T, Afzali A (2019) Inflammatory Bowel Disease: A Practical Path to Transitioning From Pediatric to Adult Care The American Journal of Gastroenterology. https://doi.org/10.14309/ajg.0000000000000347
Philpott JR, Kurowski JA (2019) Challenges in transitional care in inflammatory bowel disease: a review of the current literature in transition readiness and outcomes. Inflamm Bowel Dis. https://doi.org/10.1093/ibd/izy207
doi: 10.1093/ibd/izy207
pubmed: 29893932
Conrad MA, Rosh JR (2017) Pediatric inflammatory bowel disease. Pediatr Clin North Am. https://doi.org/10.1016/j.pcl.2017.01.005
doi: 10.1016/j.pcl.2017.01.005
pubmed: 28502439
Sauer CG, Kugathasan S (2009) Pediatric inflammatory bowel disease: highlighting pediatric differences in IBD. Gastroenterol Clin North Am. https://doi.org/10.1016/j.gtc.2009.07.010
doi: 10.1016/j.gtc.2009.07.010
pubmed: 19913205
Chaparro M, Garre A, Ricart E, Iglesias-Flores E, Taxonera C, Domènech E et al (2019) Differences between childhood- and adulthood-onset inflammatory bowel disease: the CAROUSEL study from GETECCU. Aliment Pharmacol Ther. https://doi.org/10.1111/apt.15114
doi: 10.1111/apt.15114
pubmed: 30637837
Corica D, Romano C (2017) Biological therapy in pediatric inflammatory bowel disease: a systematic review. J Clin Gastroenterol. https://doi.org/10.1097/MCG.0000000000000696
doi: 10.1097/MCG.0000000000000696
pubmed: 27636407
Steinberg JM, Charabaty A (2020) The management approach to the adolescent IBD patient: health maintenance and medication considerations. Curr Gastroenterol Rep. https://doi.org/10.1007/s11894-019-0741-7
doi: 10.1007/s11894-019-0741-7
pubmed: 32671616
van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Fagerberg UL et al (2020) The medical management of Paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update. J Crohn’s Colitis 15:171
doi: 10.1093/ecco-jcc/jjaa161
Sairenji T, Collins KL, Evans DV (2017) An update on inflammatory bowel disease. Prim Care. https://doi.org/10.1016/j.pop.2017.07.010
doi: 10.1016/j.pop.2017.07.010
pubmed: 29132528
Weissberg-Benchell J, Shapiro JB (2017) A review of interventions aimed at facilitating successful transition planning and transfer to adult care among youth with chronic illness. Pediatr Ann. https://doi.org/10.3928/19382359-20170421-01
doi: 10.3928/19382359-20170421-01
pubmed: 28599025
Menon T, Afzali A (2019) Inflammatory bowel disease: a practical path to transitioning from pediatric to adult care. Am J Gastroenterol. https://doi.org/10.14309/ajg.0000000000000222
doi: 10.14309/ajg.0000000000000222
pubmed: 30985298
Testa A, Giannetti E, Rispo A, Rea M, Miele E, Esposito S et al (2019) Successful outcome of the transitional process of inflammatory bowel disease from pediatric to adult age: a five years experience. Digest Liver Dis. https://doi.org/10.1016/j.dld.2018.11.034
doi: 10.1016/j.dld.2018.11.034
Otto C, Tárnok A, Erős A, Szákcs Z, Vincze Á, Farkas N et al (2019) Planned transition of adolescent patients with inflammatory bowel disease results in higher remission rates. J Pediatric Nurs. https://doi.org/10.1016/j.pedn.2019.02.003
doi: 10.1016/j.pedn.2019.02.003
García-Rodríguez F, Raygoza-Cortez K, Moreno-Hernandez L, García-Pérez R, Garza Lopez LE, Arana-Guajardo AC, Jáquez-Quintana JO, Villarreal-Treviño AV, de la Cavazos ME, Rubio-Pérez N (2022) Outcomes of transitional care programs on adolescent chronic inflammatory systemic diseases: systematic review and meta-analyses. Pediatric Rheumatol Online J 20(1):15. https://doi.org/10.1186/s12969-022-00670-1
doi: 10.1186/s12969-022-00670-1
Brooks G, Gazzaneo M, Bertozzi M, Riccipetitoni G, Raffaele A (2023) Systematic review of long term follow-up and transitional care in adolescents and adults with esophageal atresia—why is transitional care mandatory? Eur J Pediatr 182(5):2057–2066. https://doi.org/10.1007/s00431-023-04893-6
doi: 10.1007/s00431-023-04893-6
pubmed: 36905437
pmcid: 10175361