Hideki Kumagai1, Takahiro Kudo2, Keiichi Uchida3, Reiko Kunisaki4, Akira Sugita5, Yoshikazu Ohtsuka2, Katsuhiro Arai6, Mitsuru Kubota7, Hitoshi Tajiri8, Yasuo Suzuki9, Toshiaki Shimizu2. 1. Department of Pediatrics, Jichi Medical University, Shimotsuke City, Tochigi, Japan. 2. Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Bunkyo, Tokyo, Japan. 3. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan. 4. Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama City, Kanagawa, Japan. 5. Inflammatory Bowel Disease Center, Yokohama Municipal Hospital, Yokohama City, Kanagawa, Japan. 6. Division of Gastroenterology, National Center for Child Health and Development, Setagaya, Tokyo, Japan. 7. Division of General Practice, National Center for Child Health and Development, Setagaya, Tokyo, Japan. 8. Department of Pediatrics, Osaka General Medical Center, Toshima, Osaka, Japan. 9. Inflammatory Bowel Disease Center, Sakura Medical Hospital, Toho University Medical Center, Sakura City, Chiba, Japan.
Abstract
BACKGROUND: In 2018, Japanese guidelines for autonomy support of patients with inflammatory bowel disease (IBD) in the transitional period were published. These guidelines, however, were prepared mainly by pediatric gastroenterologists. In order to improve such supportive guidelines, it is necessary for pediatric gastroenterologists to be aware of the attitudes and expectations of adult gastroenterologists. Accordingly, the first Japanese national survey designed to explore the views of adult gastroenterologists regarding successful transitional care was conducted. METHODS: The survey involved institutions at which adult gastroenterologists in the Ministry of Health, Labor and Welfare of Japan's Inflammatory Bowel Diseases Study Group, were working. Physicians were contacted by conventional mail, and their answers were not anonymized. A total of 100 eligible adult institutions were identified. Further specific subgroup analysis was conducted. RESULTS: A response rate of 34% was achieved. Seventy-six percent of the respondents had experienced some degree of difficulty when accepting patients with childhood-onset IBD referred from pediatric gastroenterologists. With regard to the ideal form of medical care for adolescent patients with IBD, transfer to adult care was supported by 94% of the respondents. Only 27% of respondents, however, stated they would have no hesitation in accepting patients referred from pediatric care centers. Two crucial areas requiring improvement were identified: inadequate clinical summaries and lack of patient independence from their parents/caregivers. CONCLUSIONS: The present survey results reinforce the importance of a transitional program of education for childhood-onset IBD patients and the need to improve communication between adult and pediatric gastroenterologists.
BACKGROUND: In 2018, Japanese guidelines for autonomy support of patients with inflammatory bowel disease (IBD) in the transitional period were published. These guidelines, however, were prepared mainly by pediatric gastroenterologists. In order to improve such supportive guidelines, it is necessary for pediatric gastroenterologists to be aware of the attitudes and expectations of adult gastroenterologists. Accordingly, the first Japanese national survey designed to explore the views of adult gastroenterologists regarding successful transitional care was conducted. METHODS: The survey involved institutions at which adult gastroenterologists in the Ministry of Health, Labor and Welfare of Japan's Inflammatory Bowel Diseases Study Group, were working. Physicians were contacted by conventional mail, and their answers were not anonymized. A total of 100 eligible adult institutions were identified. Further specific subgroup analysis was conducted. RESULTS: A response rate of 34% was achieved. Seventy-six percent of the respondents had experienced some degree of difficulty when accepting patients with childhood-onset IBD referred from pediatric gastroenterologists. With regard to the ideal form of medical care for adolescent patients with IBD, transfer to adult care was supported by 94% of the respondents. Only 27% of respondents, however, stated they would have no hesitation in accepting patients referred from pediatric care centers. Two crucial areas requiring improvement were identified: inadequate clinical summaries and lack of patient independence from their parents/caregivers. CONCLUSIONS: The present survey results reinforce the importance of a transitional program of education for childhood-onset IBDpatients and the need to improve communication between adult and pediatric gastroenterologists.