INFLAMMATORY BOWEL DISEASE – TRANSTIONING FROM PEDIATRIC TO ADULT CARE

Way Seah Lee, MBBS, FRCPCH, MD;
Professor, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.

Abstract
Transitioning of medical care refers to a set of purposeful, planned movement of adolescents and young adults with chronic medical and mental conditions from child-centered to adult-orientated health care system. A well-planned and executed transitioning of care is increasingly being recognized as an important yet challenging element of medical care. Approximately 25% of all inflammatory bowel disease (IBD) presents in childhood or adolescence. There is broad consensus on the necessity for the transition process to take place in a coordinated manner. However, major differences exist in the disease behaviour and progression between pediatric- and adult-onset IBD. In addition, there are also differences in pediatric and adult IBD model of care. As adolescents with IBD become adults, they need to evolve from being dependent on their family to becoming independently responsible for their own medical care. Thus, adolescents transitioning to an adult health care system need to acquire new skills in communication, decision making, personal care, assertiveness, self-determination, and advocacy. Research have showed that a well-planned, successful transition resulted in improved medication adherence, lower surgical or hospitalization rates, as well as improved health and life outcomes.