J Pediatr Gastroenterol Nutr. 2022 Feb 1;74(2):208-214.doi: 10.1097/MPG.0000000000003244.

Sara McCartney ¹, James O Lindsay ², Richard K Russell ³, Daniel R Gaya ⁴, Ian Shaw ⁵, Charlie D Murray ⁶, Tricia Finney-Hayward ⁷, Shaji Sebastian ⁸

Author information

¹University College London Hospitals NHS Foundation Trust.

²Barts Health NHS Trust, London.

³The Royal Hospital for Sick Children, Edinburgh.

⁴NHS Greater Glasgow and Clyde, Glasgow.

⁵Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.

⁶Royal Free London NHS Foundation Trust, London.

⁷AbbVie, Maidenhead.

⁸Hull University Teaching Hospitals NHS Trust, Hull, UK.

Abstract

Objective: To evaluate the impact of structured transition from pediatric to adult inflammatory bowel disease (IBD) services on objective patient outcomes, including disease flares, admission rates, and healthcare resource use.

Methods: A retrospective observational study in 11 United Kingdom gastroenterology centers. Transition patients attended ≥2 visits to the gastroenterology service with both pediatric and adult personnel jointly present; non-transition patients transferred to adult services without joint visits. Data were collected from medical records for the 12-month periods before and after the date of the first visit involving adult IBD services (index visit).

Results: A total of 129 patients were included: 95 transition patients and 34 non-transition patients. In the 12 months post-index visit, transition patients had fewer disease flares (P = 0.05), were more likely to be steroid-free (71% vs 41%, P < 0.05), and were less likely to have an emergency department visit leading to hospital admission (5% vs 18%, P < 0.05). During this period, the mean estimated overall cost of care per patient was £1644.22 in the transition group and £1827.32 in the non-transition group (P = 0.21).

Conclusion: Structured transition from pediatric to adult IBD care services was associated with positive and cost-neutral outcomes in patients with pediatric IBD.