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Benefits of Paediatric to Adult Transition Programme in Inflammatory Bowel Disease: The BUTTERFLY Study of GETECCU and SEGHNP.

Cristina Rubín de CélixJavier Martín-de-CarpiGemma Pujol-MuncunillLaura María PalominoMarta Velasco Rodríguez-BelvísRafael Martín-MasotVíctor Manuel Navas-LópezElena RicartMaría José CasanovaAlejandro Rodriguez-MartinezEduardo Leo-CarnereroAlba AlcarazMiriam MañosaVicent Hernandez RamirezMaría Consuelo Cobelas CobelasCésar SánchezLuis MenchénFrancisco MesoneroManuel Barreiro-de AcostaNazareth Martinón-TorresCoral Tejido SandovalAlicia Rendo VázquezPilar CorsinoRaquel VicenteAlejandro Hernández CambaJosé Ramón Alberto AlonsoInmaculada Alonso-AbreuAna María Castro MillánLaia Peries ReverterBeatriz CastroEstela Fernández-SalgadoM Mercedes Busto CuiñasJosé Manuel BenítezLucía MaderoFernando ClementeSabino RiestraSantiago Jiménez-TreviñoMaia Boscá-WattsElena Crehuá-GaudizaMarta Calvo MoyaJose Maria HuguetEster-María Largo-BlancoLeticia González VivesRocío Plaza-SantosIvan GuerraJosefa BarrioLaura EscartínErika AlfambraNoelia CruzM Carmen MuñozMaría Guadalupe Muñoz PinoManuel Van DomselaarBelén BotellaDavid Monfort MiquelM Carmen Rodríguez GrauAgustín De La ManoYolanda Ber NietoMaría Calvo IñiguezTeresa de Jesús Martínez-PérezMaria ChaparroFrancisco Javier García-Alonso
Published in: Journal of clinical medicine (2023)
(1) Background: Transition is a planned movement of paediatric patients to adult healthcare systems, and its implementation is not yet established in all inflammatory bowel disease (IBD) units. The aim of the study was to evaluate the impact of transition on IBD outcomes. (2) Methods: Multicentre, retrospective and observational study of IBD paediatric patients transferred to an adult IBD unit between 2017-2020. Two groups were compared: transition (≥1 joint visit involving the gastroenterologist, the paediatrician, a programme coordinator, the parents and the patient) and no-transition. Outcomes within one year after transfer were analysed. The main variable was poor clinical outcome (IBD flare, hospitalisation, surgery or any change in the treatment because of a flare). Predictive factors of poor clinical outcome were identified with multivariable analysis. (3) Results: A total of 278 patients from 34 Spanish hospitals were included. One hundred eighty-five patients (67%) from twenty-two hospitals (65%) performed a structured transition. Eighty-nine patients had poor clinical outcome at one year after transfer: 27% in the transition and 43% in the no-transition group ( p = 0.005). One year after transfer, no-transition patients were more likely to have a flare (36% vs. 22%; p = 0.018) and reported more hospitalisations (10% vs. 3%; p = 0.025). The lack of transition, as well as parameters at transfer, including IBD activity, body mass index < 18.5 and corticosteroid treatment, were associated with poor clinical outcome. One patient in the transition group (0.4%) was lost to follow-up. (4) Conclusion: Transition care programmes improve patients' outcomes after the transfer from paediatric to adult IBD units. Active IBD at transfer impairs outcomes.
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