Transition from pediatric to adult care

One role of the pediatric gastroenterologist is to help adolescents become self-sufficient as they approach an age when they will shift care to adult medicine. From surveys of adult gastroenterologists, there is a need for significant improvement in transition of care. These surveys discovered that over half of the young patients moving from pediatric providers have deficits in their knowledge about their disease, and 69 % could not provide their medical regimen. Planning for successful transition should include starting early in adolescence, asking family and healthcare providers to foster independence, and confirming with the young adult that there is a desire to become self-sufficient. Education should begin by 12-14 years of age and laying a foundation for independence by 14-17 years. By age 17-18 years the focus should be on self-management and healthy life styles. Parents and the pediatric medical team all have to be encouraged to participate in this process if transition is to be successful. At the time of transfer of care it is important to provide all of the important history and prior treatment for the adult gastroenterologist to make sure adequate care continues. It is also useful to follow-up to be sure the young adult patient has transitioned successfully and is continuing to receive ongoing care.