Journal of Clinical Medicine (Jul 2023)

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

  • Cristina Rubín de Célix,
  • Javier Martín-de-Carpi,
  • Gemma Pujol-Muncunill,
  • Laura María Palomino,
  • Marta Velasco Rodríguez-Belvís,
  • Rafael Martín-Masot,
  • Víctor Manuel Navas-López,
  • Elena Ricart,
  • María José Casanova,
  • Alejandro Rodríguez-Martínez,
  • Eduardo Leo-Carnerero,
  • Alba Alcaraz,
  • Miriam Mañosa,
  • Vicent Hernández,
  • María Consuelo Cobelas Cobelas,
  • César Sánchez,
  • Luis Menchén,
  • Francisco Mesonero,
  • Manuel Barreiro-De Acosta,
  • Nazareth Martinón-Torres,
  • Coral Tejido Sandoval,
  • Alicia Rendo Vázquez,
  • Pilar Corsino,
  • Raquel Vicente,
  • Alejandro Hernández-Camba,
  • José Ramón Alberto Alonso,
  • I. Alonso-Abreu,
  • Ana María Castro Millán,
  • Laia Peries Reverter,
  • Beatriz Castro,
  • Estela Fernández-Salgado,
  • M. Mercedes Busto Cuiñas,
  • José Manuel Benítez,
  • Lucía Madero,
  • Fernando Clemente,
  • Sabino Riestra,
  • Santiago Jiménez-Treviño,
  • Maia Boscá-Watts,
  • Elena Crehuá-Gaudiza,
  • Marta Calvo Moya,
  • José María Huguet,
  • Ester-María Largo-Blanco,
  • Leticia González Vives,
  • Rocío Plaza,
  • Iván Guerra,
  • Josefa Barrio,
  • Laura Escartín,
  • Erika Alfambra,
  • Noelia Cruz,
  • M. Carmen Muñoz,
  • María Guadalupe Muñoz Pino,
  • Manuel Van Domselaar,
  • Belén Botella,
  • David Monfort Miquel,
  • M. Carmen Rodríguez Grau,
  • Agustín De La Mano,
  • Yolanda Ber,
  • María Calvo Iñiguez,
  • Teresa de Jesús Martínez-Pérez,
  • María Chaparro,
  • Javier P. Gisbert

DOI
https://doi.org/10.3390/jcm12144813
Journal volume & issue
Vol. 12, no. 14
p. 4813

Abstract

Read online

(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.

Keywords