title: Perspectives of paediatric and adult gastroenterologists on transfer and transition care of adolescents with inflammatory bowel disease.
abstract: BACKGROUND
  Programmes specific to inflammatory bowel disease (IBD) that facilitate transition from paediatric to adult care are currently lacking.
  
  
  OBJECTIVE
  We aimed to explore the perceived needs of adolescents with IBD among paediatric and adult gastroenterologists and to identify barriers to effective transition.
  
  
  METHODS
  A web-based survey of paediatric and adult gastroenterologists in Australia and New Zealand employed both ranked items (Likert scale; from 1 not important to 5 very important) and forced choice items regarding the importance of various factors in facilitating effective transition of adolescents from paediatric to adult care.
  
  
  RESULTS
  Response rate among 178 clinicians was 41%. Only 23% of respondents felt that adolescents with IBD were adequately prepared for transition to adult care. Psychological maturity (Mean = 4.3, standard deviation (SD) = 0.70) and readiness as assessed by adult caregiver (Mean = 4, SD = 0.72) were prioritised as the most important factors in determining timing of transfer. Self-efficacy and readiness as assessed by adult caregiver were considered the two most important factors to determine timing of transition by both groups of gastroenterologists. Poor medical and surgical handover (Mean = 4.10, SD = 0.8) and patients' lack of responsibility for their own care (Mean= 4.10, SD = 0.82) were perceived as major barriers to successful transition by both paediatric and adult gastroenterologists.
  
  
  CONCLUSIONS
  Deficiencies exist in current transition care of adolescents with IBD in Australia and New Zealand. Standardising transition care practices with strategies aimed at optimising communication, patient education, self-efficacy and adherence may improve outcomes.
authors.affiliation: Department of Gastroenterology, St Vincent's Hospital and University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: E K
authors.initials: EK
authors.lastname: Wright
authors.forename: J
authors.initials: J
authors.lastname: Williams
authors.forename: J M
authors.initials: JM
authors.lastname: Andrews
authors.forename: A S
authors.initials: AS
authors.lastname: Day
authors.forename: R B
authors.initials: RB
authors.lastname: Gearry
authors.forename: P
authors.initials: P
authors.lastname: Bampton
authors.forename: D
authors.initials: D
authors.lastname: Moore
authors.forename: D
authors.initials: D
authors.lastname: Lemberg
authors.forename: R
authors.initials: R
authors.lastname: Ravikumaran
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: P
authors.initials: P
authors.lastname: Lewindon
authors.forename: G
authors.initials: G
authors.lastname: Radford-Smith
authors.forename: J
authors.initials: J
authors.lastname: Rosenbaum
authors.forename: A
authors.initials: A
authors.lastname: Catto-Smith
authors.forename: P V
authors.initials: PV
authors.lastname: Desmond
authors.forename: W R
authors.initials: WR
authors.lastname: Connell
authors.forename: D
authors.initials: D
authors.lastname: Cameron
authors.forename: G
authors.initials: G
authors.lastname: Alex
authors.forename: S J
authors.initials: SJ
authors.lastname: Bell
authors.forename: P
authors.initials: P
authors.lastname: De Cruz
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine; D000328:Adult; D001315:Australia; D017028:Caregivers; D003142:Communication; D005762:Gastroenterology; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D033183:Interdisciplinary Communication; D008962:Models, Theoretical; D010353:Patient Education as Topic; D062209:Patient Handoff; D010372:Pediatrics; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011364:Professional Practice / Q000706:statistics & numerical data; D000297:Psychology, Adolescent; D020377:Self Efficacy; D012955:Societies, Medical; D013997:Time Factors; D060305:Transition to Adult Care; D055815:Young Adult
keywords: adolescent; inflammatory bowel disease; transfer; transition