Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.
Inflamm Bowel Dis. 2020 Feb 11;26(3):331-346. doi: 10.1093/ibd/izz173.
BACKGROUND: Transition of adolescents from pediatric to adult care is of great importance in the management of inflammatory bowel disease (IBD). Our aim was to review and summarize the currently applied interventions and outcomes related to transition practices in IBD. METHODS: A systematic review was performed in accordance with the PRISMA Statement. We searched PubMed, EMBASE, CENTRAL, and Web of Science databases up to February 15, 2019. Controlled studies evaluating adolescents and young adults with IBD participating in structured transition interventions or patient educational programs and single-arm (before-after) studies were included. Several individual, health care, and social outcomes were assessed. The PROSPERO registration number is CRD42019118520. RESULTS: A total of 23 articles were eligible for qualitative synthesis. Eleven studies compared an intervention to a control group, whilst 12 studies were uncontrolled before-after studies. The age of the participants varied from 11 to 25 years. The most common structured transition interventions were joint visits and patient education programs. IBD nurses were operating as nominated transition coordinators in the transition process. Quality of life, patient satisfaction, self-efficacy, disease-specific knowledge, adherence rate, and nonattendance rate at outpatient clinic were identified as main health care transition outcomes besides disease-related outcomes. Despite the various study designs and methodological limitations, outcomes improved with the application of structured transition interventions in eleven of the studies. CONCLUSION: These results facilitate the design of randomized controlled trials along better standards in transitional care in IBD.
背景:青少年从儿科向成人护理的过渡在炎症性肠病(IBD)的管理中非常重要。我们的目的是回顾和总结目前应用于 IBD 过渡实践的干预措施和结果。
方法:我们按照 PRISMA 声明进行了系统评价。我们搜索了 PubMed、EMBASE、CENTRAL 和 Web of Science 数据库,检索截至 2019 年 2 月 15 日。纳入评估接受结构化过渡干预或患者教育计划的 IBD 青少年和年轻人的对照研究以及单臂(前后)研究。评估了几个个体、医疗保健和社会结果。PROSPERO 注册号为 CRD42019118520。
结果:共有 23 篇文章有资格进行定性综合分析。11 项研究将干预措施与对照组进行了比较,而 12 项研究则是未经对照的前后研究。参与者的年龄从 11 岁到 25 岁不等。最常见的结构化过渡干预措施是联合就诊和患者教育计划。IBD 护士在过渡过程中担任指定的过渡协调员。除疾病相关结果外,生活质量、患者满意度、自我效能、疾病特定知识、遵医嘱率和门诊就诊不依从率被确定为主要医疗保健过渡结果。尽管存在各种研究设计和方法学限制,但在 11 项研究中,应用结构化过渡干预措施可改善结果。
结论:这些结果为 IBD 过渡护理制定随机对照试验和更好的标准提供了便利。
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