title: The requirements and barriers to successful transition of adolescents with inflammatory bowel disease: differing perceptions from a survey of adult and paediatric gastroenterologists.
abstract: OBJECTIVE
  Preliminary data highlight the importance of appropriate transition for successful transfer of adolescents with IBD from paediatric to adult care. The aim of this study was to identify both the perceived needs of adolescent IBD patients and the barriers to successful transition from the perspective of professionals involved in their care.
  
  
  METHODS
  A postal questionnaire was distributed to UK adult and paediatric gastroenterologists with an interest in IBD. The questionnaire utilised closed questions as well as ranked items on the importance of the various competencies of adolescents with IBD required for successful transition.
  
  
  RESULTS
  Response rate of 62% and 49% for paediatric and adult gastroenterologists respectively was achieved. A structured transition service was perceived as very important by 80% paediatric compared to 47% adult gastroenterologists (p=0.001). A higher proportion of adult than paediatric gastroenterologists identified inadequacies in the preparation of adolescents for transfer (79% and 42%, p=0.001). The main areas of perceived deficiency in preparation identified were patient lack of knowledge about the condition and treatment, lack of self advocacy and co-ordination of care. Lack of resources, clinical time, and a critical mass of patients were the factors ranked highest by both groups as barriers to transition care. Both adult (65%) and paediatric gastroenterologists (62%) highlighted suboptimal training in adolescent medicine for adult gastroenterologists.
  
  
  CONCLUSIONS
  This survey highlights differences in the perception of adult and paediatric gastroenterologists in the management of transition care and perceived competencies for adolescents with IBD. Lack of training and inadequate resources are the main barriers identified for development of a successful transition service.
authors.affiliation: Hull & East Yorkshire NHS Trust, Hull, UK. shaji.sebastian@hey.nhs.uk
authors.forename: Shaji
authors.initials: S
authors.lastname: Sebastian
authors.forename: Huw
authors.initials: H
authors.lastname: Jenkins
authors.forename: Sarah
authors.initials: S
authors.lastname: McCartney
authors.forename: Tariq
authors.initials: T
authors.lastname: Ahmad
authors.forename: Ian
authors.initials: I
authors.lastname: Arnott
authors.forename: Nick
authors.initials: N
authors.lastname: Croft
authors.forename: Richard
authors.initials: R
authors.lastname: Russell
authors.forename: James O
authors.initials: JO
authors.lastname: Lindsay
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D005762:Gastroenterology / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D010372:Pediatrics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care / Q000706:statistics & numerical data; D006113:United Kingdom; D055815:Young Adult