Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary.
Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary.
J Pediatr Nurs. 2019 Mar-Apr;45:62-66. doi: 10.1016/j.pedn.2019.02.003. Epub 2019 Feb 10.
To evaluate the effect of our current transition process on clinical outcomes in adolescent patients with inflammatory bowel diseases (IBD).
Two groups of patients with IBD diagnosed in pediatric care were compared retrospectively: Group A patients did not attend the transition process, while Group B patients entered the planned transition service. Outcomes at 1-year after transfer to adult care were evaluated.
Forty-five patients with IBD diagnosed under the age of 18 years were identified of whom 35 had Crohn's disease and 10 had ulcerative colitis. Twenty-four patients were in Group A (without transition), and 21 patients in Group B (with at least one planned transition visit). Mean age at diagnosis was 15.1 ± 2.2 and 13.7 ± 3.0 years (p = 0.086), respectively. There were no significant differences in disease duration before transfer, Montreal classification at diagnosis, body mass index, anti-TNF therapy usage, and disease status at transfer between the two groups. A significantly higher number of Group B patients were in remission at 12 months after transfer when compared to patients in Group A (11 vs. 18, respectively, p = 0.037). There was a significant difference between groups regarding the number of scheduled visits within the examined period (9 vs. 16, p = 0.011, respectively).
Planned transition visits resulted in higher disease remission rate at 1-year follow-up after transfer from pediatric to adult health care system in adolescent patients with IBD.
Well-established transition programs in IBD are needed.
评估我们目前的过渡流程对青少年炎症性肠病(IBD)患者临床结局的影响。
回顾性比较了在儿科护理中诊断为 IBD 的两组患者:A 组患者未参加过渡流程,而 B 组患者则参加了计划中的过渡服务。评估了转入成人护理后的 1 年转归。
确定了 45 名年龄在 18 岁以下诊断为 IBD 的患者,其中 35 名患有克罗恩病,10 名患有溃疡性结肠炎。24 名患者在 A 组(无过渡),21 名患者在 B 组(至少有一次计划过渡就诊)。诊断时的平均年龄分别为 15.1±2.2 岁和 13.7±3.0 岁(p=0.086)。两组间在转院前的病程、诊断时的蒙特利尔分类、体重指数、抗 TNF 治疗的使用以及转院时的疾病状态均无显著差异。与 A 组相比,B 组在转院后 12 个月时缓解的患者明显更多(分别为 11 例和 18 例,p=0.037)。在检查期间,两组的预约就诊次数有显著差异(分别为 9 次和 16 次,p=0.011)。
在从儿科到成人医疗保健系统的过渡中,计划的过渡就诊可使青少年 IBD 患者在转院后 1 年的随访中达到更高的疾病缓解率。
IBD 中需要建立完善的过渡项目。