Benefits of Paediatric to Adult Transition Programme in Inflammatory Bowel Disease: The BUTTERFLY Study of GETECCU and SEGHNP
Authors: Rubín de Célix Cristina , Martín-de-Carpi Javier , Pujol-Muncunill Gemma , Palomino Laura María , Velasco Rodríguez-Belvís Marta , Martín-Masot Rafael , Navas-López Víctor Manuel , Ricart Elena , Casanova María José , Rodríguez-Martínez Alejandro , Leo-Carnerero Eduardo , Alcaraz Alba , Mañosa Miriam , Hernández Vicent , Cobelas Cobelas María Consuelo , Sánchez César , Menchén Luis , Mesonero Francisco , Barreiro-De Acosta Manuel , Martinón-Torres Nazareth , Tejido Sandoval Coral , Rendo Vázquez Alicia , Corsino Pilar , Vicente Raquel , Hernández-Camba Alejandro , Alberto Alonso José Ramón , Alonso-Abreu I. , Castro Millán Ana María , Peries Reverter Laia , Castro Beatriz , Fernández-Salgado Estela , Busto Cuiñas M. Mercedes , Benítez José Manuel , Madero Lucía , Clemente Fernando , Riestra Sabino , Jiménez-Treviño Santiago , Boscá-Watts Maia , Crehuá-Gaudiza Elena , Calvo Moya Marta , Huguet José María , Largo-Blanco Ester-María , González Vives Leticia , Plaza Rocío , Guerra Iván , Barrio Josefa , Escartín Laura , Alfambra Erika , Cruz Noelia , Muñoz M. Carmen , Muñoz Pino María Guadalupe , Van Domselaar Manuel , Botella Belén , Monfort Miquel David , Rodríguez Grau M. Carmen , De La Mano Agustín , Ber Yolanda , Calvo Iñiguez María , Martínez-Pérez Teresa de Jesús , Chaparro María , Gisbert Javier P. 
Published: July 2023

(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.