Transition of Inflammatory Bowel Disease Care: Assessment of Transition Readiness Factors and Disease Outcomes in a Young Adult Population. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Rosen, Danya; Annunziato, Rachel; Colombel, Jean Frederic; Dubinsky, Marla; Benkov, Keith
• Is Part Of: Inflammatory bowel diseases. Volume 22:Issue 3(2016:Mar.)
• Publication Date: 2016-03
• Subjects: pediatrics -- transition -- adherence; Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1097/MIB.0000000000000633
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract : Background: Limited data exist on what factors impact transition readiness and how readiness impacts short-term disease outcomes. Methods: Patients between the ages of 18 and 25 with an established inflammatory bowel disease diagnosis completed questionnaires at the time of an outpatient visit in the pediatric or adult setting, which included the Transition Readiness Assessment Questionnaire (TRAQ). After 6 months, electronic medical records were reviewed. Results: A total of 95 patients were enrolled, 46 in the adult care setting and 49 in the pediatric care setting. Patients in the adult setting had a significantly higher overall TRAQ score compared with the pediatric setting (median: 4.42 [IQR: 3.9–4.6] versus 4.06 [IQR: 3.4–4.4], P < 0.001). Logistic regression analysis demonstrated that age was independently associated with higher TRAQ scores (odds ratio: 1.49; 95 confidence interval%, 1.1–2.02). Nonadherent patients scored lower on the Managing Medications subscale (median: 4.25 [IQR: 3.3–4.8] versus 4.75 [IQR: 4.3–5.0], P < 0.01). Logistic regression showed that patients who scored <4.75 on the Medication Management subscale were 3.8 times more likely to be nonadherent than patients who scored ≥4.75 (95% confidence interval, 1.4–10.3). This remained significant after adjusting for gender and age. During the 6-month follow-up period, 9/95 patients (10%) had hospitalizations or ED visits related to inflammatory bowel disease. There were no associations between TRAQ scores and hospitalizations/ED visits. Conclusions: Age is the primary factor that drives transition readiness. Our findings suggest that administering the medication management portion of the TRAQ can be used to identify patients at risk for nonadherence. Follow-up studies are needed to determine how readiness impacts long-term disease outcomes. Abstract : Article first published online 3 February 2016.Supplemental Digital Content is Available in the Text.