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Multicenter Study
. 2025 Apr 4;19(4):jjae166.
doi: 10.1093/ecco-jcc/jjae166.

Effectiveness of Transitional Care in Inflammatory Bowel Disease; Development, Validation, and Initial Outcomes of a Transition Success Score

Martha A C van Gaalen  1 , Merel van Pieterson  1 , Petra Waaijenberg  2 , Angelika Kindermann  3 , Victorien M Wolters  4 , Alie Dijkstra  5 , Herbert van Wering  6 , Margreet Wessels  7 , Lissy de Ridder  1 , Dimitris Rizopoulos  8 , C Lauranne A A P Derikx  9 , Johanna C Escher  1 ; Kids with Crohn’s, 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)
Collaborators, Affiliations
Multicenter Study

Effectiveness of Transitional Care in Inflammatory Bowel Disease; Development, Validation, and Initial Outcomes of a Transition Success Score

Martha A C van Gaalen et al. J Crohns Colitis. .

Abstract

Background and aims: The effectiveness of transition programs from pediatric to adult healthcare in adolescents with inflammatory bowel disease (IBD) is not clear, as prospective studies using validated outcome measures for transition are lacking. This study aimed to develop and validate a quantitative Transition Success Score (TSS), and to apply it in a multicenter setting to assess the effectiveness of transitional care.

Methods: The Top 10 outcome items related to a successful transition, identified through an international Delphi study with IBD stakeholders, were integrated into a generic questionnaire, the TSS. In a prospective, multicenter study, the TSS was scored by adult healthcare providers, young adult patients, and caregivers, 9-15 months after transfer of care.

Results: In 7 Dutch hospitals, 160 patients completed the TSS. The mean score was 25 (range 17-27), 25.6% of patients achieving maximum score. Hypothesis testing for construct validity revealed significant associations with characteristics related to transitional care, such as knowledge, independence, and quality of life (p < 0.005). Structural validation indicated the score was most effective at discerning lower levels of transition success. Internal consistency was acceptable (0.64). High disease burden, exacerbation during or after transfer, and certain personality profiles were associated with lower scores.

Conclusions: The TSS serves as a quantitative tool to evaluate the effectiveness of transitional care interventions and to identify IBD patients at risk of encountering challenges during the transition to adult healthcare.

Keywords: IBD; inflammatory bowel disease; transition; young adults.

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Conflict of interest statement

MvG received grant support for this study from ECCO, ErasmusMC, and Dr. Falk Pharma. PW has served on an organization board of a congress for Janssen. VW received a speakers fee from Mirum. HvW received lectures fee from the University of Tilburg and Health Investment. LdR collaboration (such as involved in industry-sponsored studies, investigator-initiated study, consultancy) with Abbvie, Eli Lilly, Takeda, Janssen, Medtronic, and Pfizer. LD has served on advisory boards or as speakers for Abbvie, Janssen, Sandoz, and Galapagos and has received independent research funding from Pfizer. JCE received grant support (not related to this study) from MSD and Abbvie, and a consulting fee from Janssen and Abbvie (Scientific Advisory Committee). MvP, AK, AD, MW, and DR have no conflict of interest. For more information see the ICMJE forms enclosed.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Overview Delphi study; consensus development. The listed items are the Top 10 items associated with a successful transition. Abbreviations: TSS, Transition Success Score; QoL, quality of life; YA, young adult.
Figure 2
Figure 2
Inclusion procedure TSS validation study. Abbreviations: TSS, Transition Success Score; YA, young adult.
Figure 3
Figure 3
Item information curves. Test Information Function showing per question how much information it provides (x-axis) at the transition success level (y-axis). Abbreviations: Q, question; TSS: Transition Success Score. −4 totally failed transition to 4 perfectly successful transition.
See this image and copyright information in PMC

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