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Benefits of Paediatric to Adult Transition Programme in Inflammatory Bowel Disease: The BUTTERFLY Study of GETECCU and SEGHNP.

Authors :
Rubín de Célix C
Martín-de-Carpi J
Pujol-Muncunill G
Palomino LM
Velasco Rodríguez-Belvís M
Martín-Masot R
Navas-López VM
Ricart E
Casanova MJ
Rodríguez-Martínez A
Leo-Carnerero E
Alcaraz A
Mañosa M
Hernández V
Cobelas Cobelas MC
Sánchez C
Menchén L
Mesonero F
Barreiro-De Acosta M
Martinón-Torres N
Tejido Sandoval C
Rendo Vázquez A
Corsino P
Vicente R
Hernández-Camba A
Alberto Alonso JR
Alonso-Abreu I
Castro Millán AM
Peries Reverter L
Castro B
Fernández-Salgado E
Busto Cuiñas MM
Benítez JM
Madero L
Clemente F
Riestra S
Jiménez-Treviño S
Boscá-Watts M
Crehuá-Gaudiza E
Calvo Moya M
Huguet JM
Largo-Blanco EM
González Vives L
Plaza R
Guerra I
Barrio J
Escartín L
Alfambra E
Cruz N
Muñoz MC
Muñoz Pino MG
Van Domselaar M
Botella B
Monfort Miquel D
Rodríguez Grau MC
De La Mano A
Ber Y
Calvo Iñiguez M
Martínez-Pérez TJ
Chaparro M
Gisbert JP
Source :
Journal of clinical medicine [J Clin Med] 2023 Jul 21; Vol. 12 (14). Date of Electronic Publication: 2023 Jul 21.
Publication Year :
2023

Abstract

(1) Background: Transition is a planned movement of paediatric patients to adult healthcare systems, and its implementation is not yet established in all inflammatory bowel disease (IBD) units. The aim of the study was to evaluate the impact of transition on IBD outcomes. (2) Methods: Multicentre, retrospective and observational study of IBD paediatric patients transferred to an adult IBD unit between 2017-2020. Two groups were compared: transition (≥1 joint visit involving the gastroenterologist, the paediatrician, a programme coordinator, the parents and the patient) and no-transition. Outcomes within one year after transfer were analysed. The main variable was poor clinical outcome (IBD flare, hospitalisation, surgery or any change in the treatment because of a flare). Predictive factors of poor clinical outcome were identified with multivariable analysis. (3) Results: A total of 278 patients from 34 Spanish hospitals were included. One hundred eighty-five patients (67%) from twenty-two hospitals (65%) performed a structured transition. Eighty-nine patients had poor clinical outcome at one year after transfer: 27% in the transition and 43% in the no-transition group ( p = 0.005). One year after transfer, no-transition patients were more likely to have a flare (36% vs. 22%; p = 0.018) and reported more hospitalisations (10% vs. 3%; p = 0.025). The lack of transition, as well as parameters at transfer, including IBD activity, body mass index < 18.5 and corticosteroid treatment, were associated with poor clinical outcome. One patient in the transition group (0.4%) was lost to follow-up. (4) Conclusion: Transition care programmes improve patients' outcomes after the transfer from paediatric to adult IBD units. Active IBD at transfer impairs outcomes.

Details

Language :
English
ISSN :
2077-0383
Volume :
12
Issue :
14
Database :
MEDLINE
Journal :
Journal of clinical medicine
Publication Type :
Academic Journal
Accession number :
37510928
Full Text :
https://doi.org/10.3390/jcm12144813