What is Transition?
“IBD Transition” is the process by which adolescents with inflammatory bowel disease are prepared to move from child-centered healthcare system to the adult-oriented healthcare system.
To TopThe General Steps Involved In Transition
The process of transition can be divided into 3 parts:
- Pre-Transfer of Care
Your pediatric IBD Specialist will inform you that you will need to have your care transferred to the adult IBD specialist when you become an adult (you probably knew this, as it would be kind of weird to be going to the pediatric clinic when you are 30 years old).
During this period of your care, you will be required to become more involved in the appointments – both to answer questions about yourself and to learn more about your disease and the investigations and treatments from the team. In essence, the focus of pediatric appointments shifts to you as the patient.
While initially you will often see the physician with your parents present, over time you will begin to see the physician/nurse alone for all or a portion of the appointment. It is important that you see this change positively, and as a sign that you are growing up.
You should work together with your Pediatric IBD specialist to know your medical history and to know the timing and process of transition – ask your doctor if you have not discussed this.
2. Transfer of Care
At the time of care transfer, your pediatric IBD specialist will make a referral to the adult IBD specialist. This referral will usually be in the form of a letter which outlines this history of your IBD, including your symptoms, the investigations, treatments and your response to treatment.
Upon receipt of this referral letter, the adult IBD specialist will then make an appointment for you to be seen in the adult IBD clinic. The date of the transfer is the date of your 1st appointment in the adult clinic. Prior to this date, you should feel free to contact the pediatric clinic if you have questions. However, once you have had your first appointment in the adult clinic, you should only contact the adult clinic. It is important to have clarity into who is advising you in regard to your IBD care.
In the unlikely event that you are hospitalized around the time of transfer, you may be admitted to the adult hospital. This would be considered your official transfer of care.
3. Post-Transfer of Care
Your parents are welcome to attend the first appointment with the adult IBD Specialist, but only at your request. Ideally, you should be able to answer all questions and have questions of your own. We understand that patients are unique and some may be more ready for this transfer than others.
In adult care, you will be contacted directly and you are expected to make your own appointments. In addition, you are the only one that can access your medical records. It is up to you if you want to share this information with your parents or anyone else.
You will continue to learn about long-term management and medication options in adult care; you are responsible to make informed decisions about your care and treatment options. The IBD team will provide you with information to help you in these decisions.
For more information on transition and how you can be prepared see Transition Skills OR check out this 2014 video of pediatric and adult gastroenterologists discussing transition: