WORLD GASTROENTEROLOGY NEWS Official e-newsletter of the World Gastroenterology Organisation VOL. 21, ISSUE 3 NOVEMBER 2016 In this issue www.worldgastroenterology.org Anita Afzali MD, MPH Director, Inflammatory Bowel Diseases Program Endoscopy: The Future is Wireless, University of Washington Medicine - Harborview Medical Center Indeed Konstantinos Triantafyllou, MD, PhD, FEBGH Chrysoula Malli, MD Continued on page 4 Pediatric-to-Adult Transition of Care in Inflammatory Bowel Disease: A common and necessary process Inflammatory bowel disease (IBD) is a heterogeneous group of diseases that includes both ulcerative colitis (UC) and Crohn’s disease (CD). Approximately 30% of CD and 20% of UC patients have disease onset prior to the age of 20 and the incidence of pediatric IBD is rising1. Similar to other chronic diseases such as cystic fibrosis, children with IBD will eventually require transition to adult care. This requires careful attention, collaboration and coordination to ensure best outcomes for a vulnerable population. The transition of care is a “purposeful planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health care systems”2. This should not be mistaken for a transfer of care, which is a single event and a simple “planned movement of patient and their medical records from one provider to another at a distinct point in time”3. Pediatric versus Adult Healthcare Models in IBD: The pediatric healthcare model is family-focused and is usually designed to include a multi-disciplinary team. It requires parental or caregiver involvement for knowledge, understanding, guidance and consent4,5. Unlike the pediatric model, the adult healthcare model is one which promotes individualized care and independence4,5. There is also less familiarity of the adult provider on issues related to adolescent growth and development and child-specific psychosocial needs. Despite differences in the healthcare models, there are also overlapping events such as school graduations, moving away from home, financial independence, marriage and pregnancy, which may further impact the timing of transi-tion, there may also be less oversight available by parent or caregiver, as well as economic barriers or access to health care and issues with adherence to treatment. Differences Between Pediatric and Adult IBD: Adolescents with IBD are more likely to have more severe complex disease, including more extensive CD or UC involvement, higher risk for perianal disease, and are more likely to require use of biologic agents and immunomodulator therapy, and are at a WGO Guidelines and Cascades — Development process and methodology Anton LeMair, MD
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