Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2017; 23(18): 3349-3355
Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3349
Chronological age when healthcare transition skills are mastered in adolescents/young adults with inflammatory bowel disease
Natalie Stollon, Yi Zhong, Maria Ferris, Suneet Bhansali, Brian Pitts, Eniko Rak, Maureen Kelly, Sandra Kim, Miranda A L van Tilburg
Natalie Stollon, School of Social Work, University of Washington, Seattle, WA 98105, United States
Yi Zhong, Department of Economics, University of North Carolina, Chapel Hill, NC 27599, United States
Maria Ferris, Maureen Kelly, Brain Pitts, Department of Pediatrics, University of North Carolina, School of Medicine, Chapel Hill, NC 27599, United States
Suneet Bhansali, Department of Pediatrics, NYU School of Medicine, New York, NY 10016, United States
Eniko Rak, Department of Allied Health Sciences, University of North Carolina, School of Medicine, Chapel Hill, NC 27599, United States
Sandra Kim, Department of Pediatrics, Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, United States
Miranda AL van Tilburg, Department of Clinical Research, Campbell University, College of Pharmacy and Health Sciences, Buies Creek, NC 27506, United States
Miranda AL van Tilburg, Department of Gastroenterology and Hepatology, the University of North Carolina, School of Medicine, Chapel Hill, NC 27599, United States
Author contributions: Stollon N assisted with literature review and manuscript preparation; Zhong Y was responsible for database management, performed all data analyses and assisted in manuscript preparation; Ferris M, Bhansali S, Pitts B and Rak E assisted with the data collection, data analysis/interpretation as well as manuscript writing; Kelly M and Kim S assisted with data collection, and manuscript preparation; van Tilburg MAL was responsible for study design, and assisted with data analysis/interpretation as well as manuscript writing.
Supported by the Renal Research Institute (partially).
Institutional review board statement: The study was reviewed and approved by the UNC Institutional Review Board (Chapel Hill, NC).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors have any COI related to this paper.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Miranda AL van Tilburg, PhD, Associate Professor, Department of Clinical Research, Campbell University, College of Pharmacy and Health Sciences, Buies Creek, NC 27506, United States. vantilburg@campbell.edu
Telephone: +1-919-8430688 Fax: +1-919-8432793
Received: December 13, 2016
Peer-review started: December 14, 2016
First decision: January 19, 2017
Revised: February 4, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: May 14, 2017
Processing time: 152 Days and 7 Hours
Abstract
AIM

To describe the longitudinal course of acquisition of healthcare transition skills among adolescents and young adults with inflammatory bowel diseases.

METHODS

We recruited adolescents and young adults (AYA) with inflammatory bowel diseases (IBD), from the pediatric IBD clinic at the University of North Carolina. Participants completed the TRxANSITION Scale™ at least once during the study period (2006-2015). We used the electronic medical record to extract participants’ clinical and demographic data. We used ordinary least square regressions with robust standard error clustered at patient level to explore the variations in the levels and growths of healthcare transition readiness.

RESULTS

Our sample (n = 144) ranged in age from 14-22 years. Age was significantly and positively associated with both the level and growth of TRxANSITION Scale™ scores (P < 0.01). Many healthcare transition (HCT) skills were acquired between ages 12 and 14 years, but others were not mastered until after age 18, including self-management skills.

CONCLUSION

This is one of the first studies to describe the longitudinal course of HCT skill acquisition among AYA with IBD, providing benchmarks for evaluating transition interventions.

Keywords: Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis; Pediatrics; Healthcare transition

Core tip: Adolescent and young adult patients with inflammatory bowel diseases need to transfer from pediatric to adult care, and inadequate preparation for this transfer can have negative consequences. In the past decade, the need to prepare pediatric patients for successful healthcare transitioning has received increased attention from researchers and clinicians. However, it was not clear at what age patients usually develop these transitioning skills. It is apparent from the current study that transition skills increase with age and that many transition skills are developed in early adolescence, while some important skills (i.e., self-management) are not mastered until early adulthood. This emphasizes the need to focus on skills that are mastered at a later age and investigate barriers and interventions to assure skills are mastered before transfer to adult care.