P535 Transition in adolescents with IBD: study of a measuring instrument for transfer readiness
G. van den Brink*1, M. van Gaalen1, M. Zijlstra1, C. van der Woude2, J. Escher1
1Erasmus MC-Sophia Children's Hospital, Pediatric Gastroenterology, Rotterdam, Netherlands, 2Erasmus MC, Gastroenterology Unit, Rotterdam, Netherlands
Transition of adolescent IBD patients to adult health care is often troublesome. Transitional programs are designed to provide a successful transfer. Self-efficacy is important in the process of transition and reflects the level of independence that an adolescent thinks and says he has in dealing with his disease. In 2008, we developed an IBD-specific questionnaire measuring IBD-knowledge and self-efficacy, called "IBD-yourself". The presented follow-up study aims to evaluate the success of transition in IBD patients and to assess the predictive value of "IBD-yourself" for successful transition and transfer to adult care.
This follow-up study was performed in the study population from 2008. In 2008, 50 adolescent IBD patients attending our IBD transition clinic were recruited to complete the "IBD-yourself". In 2013, when all patients had been transferred to an adult gastroenterologist, these patients were asked to participate in this study. First, an index scoring system was developed reflecting the outcome of transition based on a) adherence to visits to the outpatient clinic b) adherence to therapy and c) qualitative evaluation of transition by the patient. Total scores reflected successful -, moderately successful- or failed transition. Secondly, the relationship between "IBD-yourself" and success of transition was studied by comparing the domains of the "IBD-yourself" to the outcome of transition. Additionally, confounding factors (demographic and disease factors) were studied in relation to success of transition.
Informed consent was obtained in 36 out of 50 patients. Transition was successful in 24 (66.7%), moderately successful in 11 (30.6%) and failed in 1 patient. Comparing success of transition to the "IBD-yourself" showed that adolescents with successful transition had significantly higher scores only on the domains "actual behavior medication use" and "actual behavior outpatient clinic". Ethnicity, age at diagnosis and transfer, IBD type, transfer to a regional hospital or the Erasmus MC or presence of a transfer letter were of no importance for success of transition. Clinical remission at time of transfer was associated with successful transition. Boys had higher rates of successful transition, while higher educational level and divorced parents appeared to have a negative impact on success of transition.
In this study we have developed a scoring system reflecting the outcome of transition. The "IBD-yourself" questionnaire did not seem predictive of successful transition. We showed that 67% of the adolescents had a successful transition after attending our IBD transition clinic.