Perspectives of patients, parents, and health care providers on facilitators of and barriers to the transition from pediatric to adult care in inflammatory bowel disease: a qualitative descriptive study.

Background: The typical transition from pediatric to adult care in patients with inflammatory bowel disease occurs with an increase in health care utilization and a decrease in adherence to medications and scheduled appointments. An effective transition could reduce negative impacts but requires identifying opportunities to improve this process. This study aims to describe barriers and facilitators of transition according to patients, parents, and health care providers.
Methods: This study used a qualitative description approach. The lead author conducted semi-structured interviews with 17 patients, 13 parents, and 15 providers recruited from Western Canada. Latent content analysis identified themes in interview transcripts.
Results: The theme of preparedness emerged across all groups as a transition facilitator. Other facilitators that emerged included patient characteristics, supportive parents, home environment, and supportive adult care team. Themes of barriers that emerged included patient factors, "hovering parents" and family factors, navigating a new health care system, and travel distance.
Conclusions: This study describes facilitators and barriers according to each stakeholder involved in the transition process. Future studies should focus on designing and evaluating interventions aimed at promoting facilitators and addressing identified barriers in patients preparing to transition from pediatric to adult care.
Competing Interests: K.I.K. has consulted to Takeda, AbbVie, and Janssen. She has received speaker payments and a quality improvement grant from Pfizer. E.W. has consulted to Nestle Health Sciences, BioJamp, Pfizer, and AbbVie and has received speaker payments from Nestle Health Sciences, Janssen, Mead Johnson Nutrition, and AbbVie. C.H.S. has served on advisory boards for Janssen, AbbVie, Takeda, Lilly, Ferring, Shire, Pfizer, Sandoz, Pharmascience, Fresenius Kabi, Amgen, Bristol Myers Squibb. She has received speaker payments from Janssen, AbbVie, Takeda, Lilly Ferring, Shire, Pfizer, Pharmascience, and Fresenius Kabi and has received materials from Takeda. The other authors have no conflicts of interest to declare.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.)