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P224. Impact of transition on clinical and developmental outcomes of young IBD patients following transfer from paediatric to adult IBD services

R.A. Cole1, N. Rao2, D. Ashok2, S. Besarovich2, A. Azaz2, S. Sebastian3, 1Hull & York Medical School, United Kingdom, 2Hull & East Yorkshire NHS Trust, United Kingdom, 3Hull & East Yorkshire NHS Trust, Hull & York Medical School, United Kingdom

Background

According to expert opinions and consensus statements, transition is considered an essential part of transfer of care of young IBD patients from paediatric services to adult IBD services. However, there is limited data on the impact of transition on measurable clinical outcomes.

Methods

Predefined clinical, developmental and psychosocial outcomes were analysed in a cohort of young IBD patients transferred to adult IBD services, in order to evaluate the impact of establishment of transition service in our institution.

Results

57 patients (37 Crohns, 18 UC, and 2 IBDU) diagnosed with IBD before age 16 went through the transition process over a 6 year period. The median age at initiation of transition was 16 years (range 15–17) and median age of transfer to adult IBD service was 18 years (range 16–19 years). The median follow up in the adult IBD service post transfer was 27 months (range 6–54 months). 93% were considered compliant to the medications prescribed and the overall ‘did not attend’ rate for clinic visits in the whole cohort was only 4%. 64% of the patients have attended clinic without parents at least on one occasion following transfer. General anaesthetic was not required in any of the patients who needed endoscopic evaluation following transfer. Eight of the patients (14%) needed one or more surgery within the period of follow up in adult service. Following transfer, hospital admission including those for surgery was recorded only in 11 patients (19%). 79% of the patients attained the adult height of within 2 SD of mid parental height and the recorded BMI at last visit in adult IBD clinic was normal (21 to 25) in 86% of the patients. 43 patients in the cohort were in continuing education and/ or employment at the time of last clinic visit. Alcohol and/ or drug dependency was recorded in 2 patients. The clinical and developmental outcomes in this cohort appear superior to our young IBD patient cohort before establishment of transition service.

Conclusion

Transition in IBD patients may aid in achieving excellent clinical and developmental outcomes in the post transfer follow up period in adult IBD services.