Effectiveness of Transitional Care in Inflammatory Bowel Disease; Development, Validation, and Initial Outcomes of a Transition Success Score - Report - MDSpire
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Effectiveness of Transitional Care in Inflammatory Bowel Disease; Development, Validation, and Initial Outcomes of a Transition Success Score
By
Martha A C van Gaalen
Merel van Pieterson
Petra Waaijenberg
Angelika Kindermann
Victorien M Wolters
Alie Dijkstra
Herbert van Wering
Margreet Wessels
Lissy de Ridder
Dimitris Rizopoulos
C Lauranne A A P Derikx
Johanna C Escher
Colitis (KiCC) Working Group for Collaborative Paediatric IBD Research in the Netherlands the Dutch Initiative on Crohn and Colitis (ICC) and Dutch Nurses Network Inflammatory Bowel Disease (NIBD) the Kids with Crohn’s
Clinical Report: Development and Validation of a Transition Success Score in IBD
Overview
This study developed and validated a quantitative Transition Success Score (TSS) to assess the effectiveness of transitional care in young adults with inflammatory bowel disease (IBD). The TSS was applied prospectively in a multicenter Dutch cohort, demonstrating acceptable internal consistency and significant associations with key transitional care factors such as knowledge, independence, and quality of life.
Background
Transitioning from pediatric to adult healthcare is a critical period for young adults with chronic conditions like IBD, requiring support to develop independence and self-management skills. Despite the importance, there is a lack of validated outcome measures to evaluate transition success. Previous research identified key outcomes for successful transition, emphasizing decision-making and self-management over disease-specific factors. This study aimed to create a validated tool to quantitatively measure transition success and evaluate transitional care programs.
Data Highlights
Parameter
Value
Number of patients completing TSS
160
Mean TSS score
25 (range 17-27)
Patients achieving maximum score
25.6%
Internal consistency (Cronbach's alpha)
0.64
Significance of associations with knowledge, independence, QoL
p < 0.005
Key Findings
The TSS was developed through a Delphi process involving international IBD healthcare experts, achieving consensus on 9 key items related to transition success.
The TSS includes 7 items on disease management assessed by healthcare providers and 2 items on patient and caregiver satisfaction.
In a prospective multicenter study, the mean TSS was 25 with 25.6% of patients achieving the maximum score, indicating a generally high level of transition success.
Construct validity was supported by significant associations between TSS and factors such as patient knowledge, independence, and quality of life (p < 0.005).
Internal consistency of the TSS was acceptable (Cronbach's alpha = 0.64), with the score being most sensitive to identifying lower levels of transition success.
Higher disease burden, exacerbations during or after transfer, and certain personality profiles were linked to lower TSS scores, identifying patients at risk for transition challenges.
Clinical Implications
The TSS provides clinicians with a validated, quantitative tool to objectively assess the success of transitional care in young adults with IBD. It can help identify patients at risk for poor transition outcomes, enabling targeted interventions to improve independence, disease knowledge, and self-management skills. Incorporating the TSS into routine practice may enhance the quality and effectiveness of transition programs.
Conclusion
The Transition Success Score is a validated measure that effectively quantifies transition outcomes in young adults with IBD, facilitating evaluation and improvement of transitional care. Its use can support healthcare providers in optimizing patient independence and satisfaction during this critical period.
References
van Gennep et al. 2024 -- Assessing the Impact of Transitional Care on Inflammatory Bowel Disease: Creation, Validation, and Preliminary Results of a Transition Success Score
by Martha A C van Gaalen, Merel van Pieterson, Petra Waaijenberg, Angelika Kindermann, Victorien M Wolters, Alie Dijkstra, Herbert van Wering, Margreet Wessels, Lissy de Ridder, Dimitris Rizopoulos, C Lauranne A A P Derikx, Johanna C Escher, Colitis (KiCC) Working Group for Collaborative Paediatric IBD Research in the Netherlands the Dutch Initiative on Crohn and Colitis (ICC) and Dutch Nurses Network Inflammatory Bowel Disease (NIBD) the Kids with Crohn’s, Patrick F van Rheenen, Sarah T A Teklenburg, Fiona D M van Schaik, Janneke C van der Woude, Jildou Hoekstra, Marleen de Leest, Carla Bakker, Elvira M E Besuijen-Laterveer, Esther Adriaanse, Jolien Wisse, Marloes Heida, Pamela Hurkmans, Nynke Boontje, Tessa Z Toonen, Wendy Heida
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