Benefits of Paediatric to Adult Transition Programme in Inflammatory Bowel Disease: The BUTTERFLY Study of GETECCU and SEGHNP-Reference-Cited by-同舟云学术

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

Published:2023-07-21 Issue:14 Volume:12 Page:4813
ISSN:2077-0383
Container-title:Journal of Clinical Medicine
language:en
Short-container-title:JCM

Author:

Rubín de Célix Cristina¹^ORCID,Martín-de-Carpi Javier²,Pujol-Muncunill Gemma²,Palomino Laura María³,Velasco Rodríguez-Belvís Marta³^ORCID,Martín-Masot Rafael⁴^ORCID,Navas-López Víctor Manuel⁴^ORCID,Ricart Elena⁵,Casanova María José¹^ORCID,Rodríguez-Martínez Alejandro⁶^ORCID,Leo-Carnerero Eduardo⁷^ORCID,Alcaraz Alba⁸,Mañosa Miriam⁹^ORCID,Hernández Vicent¹⁰^ORCID,Cobelas Cobelas María Consuelo¹¹,Sánchez César¹²,Menchén Luis¹³,Mesonero Francisco¹⁴,Barreiro-De Acosta Manuel¹⁵^ORCID,Martinón-Torres Nazareth¹⁶,Tejido Sandoval Coral¹⁷,Rendo Vázquez Alicia¹⁸^ORCID,Corsino Pilar¹⁹,Vicente Raquel¹⁹^ORCID,Hernández-Camba Alejandro²⁰^ORCID,Alberto Alonso José Ramón²¹^ORCID,Alonso-Abreu I.²²^ORCID,Castro Millán Ana María²³,Peries Reverter Laia²⁴,Castro Beatriz²⁵,Fernández-Salgado Estela²⁶,Busto Cuiñas M. Mercedes²⁷,Benítez José Manuel²⁸,Madero Lucía²⁹,Clemente Fernando³⁰,Riestra Sabino³¹,Jiménez-Treviño Santiago³²,Boscá-Watts Maia³³,Crehuá-Gaudiza Elena³⁴^ORCID,Calvo Moya Marta³⁵^ORCID,Huguet José María³⁶^ORCID,Largo-Blanco Ester-María³⁷,González Vives Leticia³⁸,Plaza Rocío³⁹^ORCID,Guerra Iván⁴⁰^ORCID,Barrio Josefa⁴¹^ORCID,Escartín Laura⁴²,Alfambra Erika⁴³,Cruz Noelia⁴⁴,Muñoz M. Carmen⁴⁵,Muñoz Pino María Guadalupe⁴⁶,Van Domselaar Manuel⁴⁷,Botella Belén⁴⁸,Monfort Miquel David⁴⁹,Rodríguez Grau M. Carmen⁵⁰^ORCID,De La Mano Agustín⁵¹,Ber Yolanda⁵²^ORCID,Calvo Iñiguez María⁵³,Martínez-Pérez Teresa de Jesús⁵⁴,Chaparro María¹^ORCID,Gisbert Javier P.¹^ORCID

Affiliation:

1. Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28006 Madrid, Spain

2. Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, 08950 Barcelona, Spain

3. Paediatric Gastroenterology and Nutrition Department, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain

4. Paediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Biomedical Re-search Institute of Málaga (IBIMA), 29010 Málaga, Spain

5. Gastroenterology Department, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain

6. Paediatric Gastroenterology, Hepatology and Nutrition, UGC de Pediatría, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain

7. Gastroenterology Department, Hospital Virgen del Rocío, 41013 Sevilla, Spain

8. Department of Paediatric Gastroenterology, Nutrition and Hepatology, University Hospital Germans Trias I Pujol, 08916 Badalona, Spain

9. Gastroenterology Department, Hospital Universitari Germans Trias I Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 08916 Badalona, Spain

10. Department of Gastroenterology, Xerencia Xestion Integrada de Vigo, SERGAS, Research Group in Digestive Diseases, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain

11. Department of Paediatrics, Xerencia Xestion Integrada de Vigo, SERGAS, 36312 Vigo, Spain

12. Paediatric Gastroenterology, Hepatology and Nutrition Department, Hospital General Universitario Gregorio Marañón, 28018 Madrid, Spain

13. Gastroenterology Department–CEIMI, Hospital General Universitario Gregorio Marañón, Departamento de Medicina, Universidad Complutense de Madrid, 28018 Madrid, Spain

14. Gastroenterology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain

15. Gastroenterology Department, Hospital Universitario Clínico de Santiago, 15706 Santiago de Compostela, Spain

16. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario Clínico de Santiago, 15706 Santiago de Compostela, Spain

17. Gastroenterology Department, Complejo Hospitalario Universitario de Ourense, 32005 Orense, Spain

18. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Complejo Hospitalario Universitario de Ourense, 32005 Orense, Spain

19. Inflammatory Bowel Disease Unit, Gastroenterology Department, Hospital Universitario Miguel Servet, Health Research Institute of Aragón, 50009 Zaragoza, Spain

20. Gastroenterology Department, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain

21. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain

22. Gastroenterology Department, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain

23. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain

24. Gastroenterology Department, Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain

25. Gastroenterology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain

26. Gastroenterology Department, Complejo Hospitalario Universitario de Pontevedra, 36071 Pontevedra, Spain

27. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Complejo Hospitalario Universitario de Pontevedra, 36071 Pontevedra, Spain

28. Gastroenterology Department, Hospital Universitario Reina Sofía, IMIBIC, 14004 Córdoba, Spain

29. Gastroenterology Department, Hospital Universitario de Alicante, Instituto de Investigación Sanitaria y Biomedica (ISABIAL), 03010 Alicante, Spain

30. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario de Alicante, 03010 Alicante, Spain

31. Gastroenterology Department, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain

32. Paediatric Gastroenterology and Nutrition Unit, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain

33. Gastroenterology Department, Hospital Clínico de Valencia, 46010 Valencia, Spain

34. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Clínico de Valencia, 46010 Valencia, Spain

35. Inflammatory Bowel Disease Unit, Department of Gastroenterology and Hepatology, Hospital Puerta de Hierro, 28222 Madrid, Spain

36. Gastroenterology Department, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain

37. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain

38. Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain

39. Gastroenterology Department, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain

40. Gastroenterology Department, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain

41. Paediatric Gastroenterology Unit, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain

42. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain

43. Gastroenterology Department, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain

44. Gastroenterology Department, Hospital Doctor José Molina Orosa, 35500 Las Palmas, Spain

45. Gastroenterology Department, Hospital Universitario de Basurto, 48013 Bilbao, Spain

46. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital de Torrejón, 28850 Madrid, Spain

47. Gastroenterology Department, Hospital de Torrejón, 28850 Madrid, Spain

48. Gastroenterology Department, Hospital Universitario Infanta Cristina, 28981 Madrid, Spain

49. Gastroenterology Department, Centro Consorci Sanitari Terrassa, 08227 Terrassa, Spain

50. Gastroenterology Department, Hospital de Henares, 28822 Madrid, Spain

51. Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital de Henares, 28822 Madrid, Spain

52. Gastroenterology Department, Hospital de San Jorge, 22004 Huesca, Spain

53. Gastroenterology Department, Hospital San Pedro, 28037 La Rioja, Spain

54. Gastroenterology Department, Hospital Virgen de La Luz, 16002 Cuenca, Spain

Abstract

(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.

Funder

Young Group of the Spanish Gastroenterology Association

Publisher

MDPI AG

Subject

General Medicine

Link

https://www.mdpi.com/2077-0383/12/14/4813/pdf

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