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P302. Barriers to transition care for adolescents and young adults with inflammatory bowel disease: Results of a postal survey of adult and paediatric gastroenterologists

S. Sebastian1, H. Jenkins2, I. Arnott3, N. Croft2, T. Ahmad2, S. McCartney2, R. Russell2, J. Lindsay2

1Hull & East Yorkshire NHS Trust, Hull, United Kingdom; 2Adolescent & Young Persons Section, British Society of Gastroenterology, London, United Kingdom; 3Western General Hospital, Edinburgh, United Kingdom

Introduction and Aims: Many barriers to the development of successful transition services for adolescents with chronic medical conditions from paediatric to adult care have been identified. However, there is paucity of literature regarding the barriers for successful transition services in inflammatory bowel disease. The aim of this study was to identify the perceived barriers to transition care in IBD using a postal questionnaire of paediatric and adult gastroenterologists.

Methods: A structured postal survey designed for self completion was send to paediatric gastroenterologists and adult clinicians involved in care of IBD patients. Parameters were ranked using a Likert scale with a five point response format anchored by not important to very important. Perceived barriers to transition care were also ranked. The impact of training, regional differences and hospital setting were studied.

Results: The response rate for paediatric and adult gastroenterologists was 53.7% (71/132) and 49.3% (358/729) (p = ns). The mean scores of the health care organisation and patient related factors are tabulated in table 1. Lack of resources, clinical time, and lack of critical mass of patients were the highest ranked barriers in local practice of both paediatric and adult gastroenterologists. A significant proportion of adult and paediatric gastroenterologists highlighted suboptimal training for adult gastroenterologists in the care of adolescents and young adults with chronic diseases. Transition services appear to be more established in teaching hospital setting although there were marked regional differences.

Conclusion: This survey identifies the perceived barriers to the organisation of transition services for adolescents with IBD in the UK. Patient relating and organisational issues need to be addressed.

Table 1
Potential barriersMean score ± SD
 Adult gastroenterologistsPaediatric gastroenterologists
Patients' limited understanding of condition and treatment4.12±0.813.09±0.67
Lack of self advocacy3.89±0.874.04±0.84
Parental reluctance to transition3.57±1.033.63±0.84
Lack of trust in adult clinical services3.12±0.644.19±0. 51
Patients/parent's high expectation3.59±0.973.68±0.83
Lack of funding3.59±1.223.77±1.19
Lack of interest in relevant colleagues3.08±1.243.90±1.15
Lack of space3.93±1.034.22±0.71
Lack of supportive services (nurses, admin etc)3.92±1.064.09±0.97
Lack of defined policies3.32±1.073.40±1.09

Acknowledgement: Supported by an educational grant from Warner Chilcott Pharmaceuticals.