Researchers compare a transition clinic (or outpatient clinic) to direct handover care for young people with inflammatory bowel disease.
Young people (aged 16-25) who are diagnosed with inflammatory bowel disease (IBD) often suffer from abdominal pain and fatigue. They can also suffer from depression, fear, and stress. Young people with IBD tend to miss out on some aspects of childhood and their school attendance can be compromised. For persons with IBD, transitioning into adulthood can be difficult, as patterns have shown they may refuse treatments, therefore medications may be missed, which could lead to further health complications. Due to this, the healthcare community is implementing transition clinics where both pediatric and adult professionals work together to provide the patient with the care required. Transition clinics should offer an easier transition into adult IBD care.
A recent study from the Netherlands looked at the structures and daily routines in IBD-care services. Up to hour-long interviews were conducted, and consultations were closely examined. Interview topics focused on the helpfulness of an outpatient IBD clinic, and specific details such as its structure, value, and information.
The consultation observations took place in either a direct handover or an outpatient IBD clinic. The researchers observed how transitions were carried out and how patients and professionals interacted. Participants in this study also took a survey and filled out a detailed chart. The chart was used to identify any consultations the patient may have missed.
The researchers reported that pediatric and adult professionals’ collaborations were only found in the outpatient IBD clinic setting, not within the direct handover setting
At the outpatient IBD clinic, four consultations were set up throughout the year to help the transition into adult healthcare; a pediatric professional completed three consultations and an adult professional completed one. Before each consultation, the professionals made sure to talk about the patient’s health.
Both settings discussed treatment side effects and how to live with treatment throughout the consultations. The outpatient IBD clinic setting went a little further by discussing aspects of patients’ personal lives and setting up team meetings. This included independent living, family, leisure, psychological counselling, sports, and work. This setting also included discussions about the distinctions between pediatric healthcare and adult healthcare.
The outpatient IBD clinic had more scheduled consultations, fewer relapses before transition, easier transitions to adult healthcare, fewer missed consultations and hospital admissions after transition, and an overall satisfactory experience in comparison to direct handover. Patients also had less of a chance of active IBD throughout the transition process. An important aspect of the setting was how enthusiastic the healthcare staff were. This showed patients how important it was to receive proper care. It made patients feel more confident and prepared for the transition.
There were, however, some limitations and barriers to the outpatient IBD clinic, such as lack of financial coverage and time restrictions, among others. Nonetheless, the outpatient IBD clinic setting demonstrated superior quality of care and better patient outcomes There were no differences in how patients self-managed themselves in either setting.
Written by Laura Laroche, HBASc, Medical Writer
Reference: Sattoe, Jane N T, et al. “Value of an outpatient transition clinic for young people with inflammatory bowel disease: a mixed-methods evaluation”. BMJ. Vol. 10. Online.