Provider awareness alone does not improve transition readiness skills in adolescent patients with inflammatory bowel disease.
OBJECTIVE
Adolescent patients with chronic health conditions must gradually assume responsibility for their health. Self-management skills are needed for a successful transfer from adolescent to adult health care, but the development of these skills could be resource intensive. Pediatric providers are already instrumental in teaching patients about their health and may improve these skills. The aim of the study was to evaluate whether informal education of pediatric providers regarding transition improves inflammatory bowel disease (IBD) patient self-management skills.


METHODS
Consecutive patients with IBD older than 10 years who presented to the outpatient setting were administered a survey regarding self-management behaviors in 2008 and 2011. During this time, several conferences on transition were presented to the providers.


RESULTS
In 2008, 294 patients completed the survey (82%) compared with 121 patients (89%) in 2011. The patient groups were comparable with respect to sex (boys 50% vs 42%), mean age (16.7 vs 16.2 years), and type of IBD (Crohn 68% vs 66%). The 13- to 15-year-olds reported calling in refills (11%, 8%, respectively), scheduling clinic appointment (0, 1%), preparing questions (13%, 5%), and taking the main role in talking during clinic visits (15%, 24%). The 16- to 18-year-olds reported calling in refills (13%, 27%), scheduling clinic appointments (9%, 6%), preparing questions (9%, 16%), and taking the main role in talking in clinic visits (36%, 45%). Responsibility for behaviors gradually increases with age, but did not differ significantly between 2008 and 2011.


CONCLUSIONS
Increasing awareness around transition readiness for pediatric providers had an insignificant effect on the self-management skills of patients with IBD. A more formal or structured approach is likely required to improve transition skills in adolescent patients.
*Center for Inflammatory Bowel Disease and Division of Gastroenterology and Nutrition, Boston Children's Hospital †Department of Pediatrics, Harvard Medical School, Boston, MA ‡University of Amsterdam, Amsterdam, The Netherlands §Division of Pediatric Cardiology, Lucile Packard Children's Hospital at Stanford, Palo Alto, CA.
Laurie N
LN
Fishman
Sonja I
SI
Ziniel
Max E
ME
Adrichem
Susan M
SM
Fernandes
Janis
J
Arnold
D000293:Adolescent; D000328:Adult; D001364:Awareness; D002648:Child; D003625:Data Collection; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D015212:Inflammatory Bowel Diseases; D008297:Male; D010353:Patient Education as Topic; D010372:Pediatrics; D012648:Self Care; D055815:Young Adult