Transition of adolescents with inflammatory bowel disease from pediatric to adult care

Pediatric Inflammatory Bowel Disease (IBD) patients eventually need to transition to adult settings. Transition is of interest in many chronic illnesses with childhood onset. Pediatric providers should understand adult providers' expectations to better prepare their patients. Using a recent North American survey, we explored the insights of adult gastroenterologists in the Netherlands. The survey was sent to 288 Dutch adult gastroenterologists. Respondents indicated the importance of various transition issues, and reported which problems occurred often in their practice. They also evaluated importance and personal competence regarding uniquely adolescent medical issues. A response rate of 47% was achieved. Patients' ability to discuss IBD impact on overall daily life (60%), knowledge of their medications (53%) and impact of substance use on their health (53%) were often problematic. Patients' ability to attend the visit alone (12%) or identify health care providers (9%) were infrequently problematic. While transfer of accurate medical history by pediatricians was ranked of highest importance, it was rarely problematic (14%). Academic and younger physicians reported a higher frequency of problems. Dutch gastroenterologists reported less problems than their American colleagues. Many respondents deemed medical (94%) and developmental (89%) issues in adolescence important. However, fewer respondents reported competency regarding those issues (61% and 34%, respectively). Conclusion: Pediatric providers should focus patient education on areas recognized as important and problematic by adult providers. Adolescent medical and developmental issues should be incorporated in specialist training. Dutch providers report less problems, perhaps due the proximity of pediatric and adult health facilities.