Mistakes in transitional care for children and young adults and how to avoid them

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Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra, Hans Törnblom, Jorge Amil Dias, Moriam Mustapha

Summary

AI Generated

An article outlines eight common mistakes in the transition from pediatric to adult care for adolescents with chronic diseases, a critical phase that can lead to loss of follow-up, treatment suspension, and increased complications.

The transition from child-centered to adult-oriented care is complicated by varying age limits for pediatric care and scarcity of adult centers with specific expertise.
The transition phase can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse.
Many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, with frequent shortcomings in the process.
The article identifies eight common mistakes during transition, supported by literature and professional experience, emphasizing that a well-organized transition program is essential.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8

Blum RW, Garell D, Hodgman CH, et al. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health 1993;14(7):570-6.

Davidson LF, Doyle MH Health-care Transition: A Vital Part of Care, Growth, and Change for Pediatric Patients. Pediatr Rev 2021;42(12):684-93.

Leung Y, Heyman MB, Mahadevan U Transitioning the adolescent inflammatory bowel disease patient: guidelines for the adult and pediatric gastroenterologist. Inflamm.Bowel.Dis. 2011;17(10):2169-73.

Ludvigsson JF, Agreus L, Ciacci C, et al. Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut 2016;65(8):1242-51.

Mandato C, Vajro P Insights on Transition of Care-Related Deaths of Young Adults Who Were Recipients of Pediatric Liver Transplantation. J Pediatr Gastroenterol Nutr 2022;75(5):551-52.

Stevens JP, Gillespie S, Hall L, et al. Education and Psychosocial Factors Predict Odds of Death After Transfer to Adult health Care in Pediatric Liver Transplant Patients. J Pediatr Gastroenterol Nutr 2022;75(5):623-28.

Peixoto A, Reis EMA, Trindade E, et al. Protocol for the transition of pediatrics for adult medicine in celiac disease: a proposal approach. Eur J Gastroenterol Hepatol 2019;31(6):729-30.

White P, Schmidt A, Shorr J, et al. Integrating Young Adults into Adult Health Care - Six Core Elements of Health Care Transition (TM) 3.0. Washington, DC; 2020.

Vittorio J, Kosmach-Park B, King LY, et al. Health Care Transition for Adolescents and Young Adults With Pediatric-Onset Liver Disease and Transplantation: A Position Paper by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2023;76(1):84-101.

10.

Hait EJ, Barendse RM, Arnold JH, et al. Transition of adolescents with inflammatory bowel disease from pediatric to adult care: a survey of adult gastroenterologists. J.Pediatr.Gastroenterol.Nutr. 2009;48(1):61-65.

11.

Escher JC Transition from pediatric to adult health care in inflammatory bowel disease. Dig Dis 2009;27(3):382-6.

12.

Philpott JR Transitional care in inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2011;7(1):26-32.

13.

Dellon ES, Jones PD, Martin NB, et al. Health-care transition from pediatric to adult-focused gastroenterology in patients with eosinophilic esophagitis. Dis Esophagus 2013;26(1):7-13.

14.

Gray WN, Holbrook E, Dykes D, et al. Improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator. J Pediatr Gastroenterol Nutr 2019;69(2):194-99.

15.

Ferrarese A, Germani G, Lazzaro S, et al. Short-term outcomes of paediatric liver transplant recipients after transition to Adult Healthcare Service. Liver Int 2018;38(7):1316-21.

16.

Hames A, Matcham F, Joshi D, et al. Liver transplantation and adolescence: The role of mental health. Liver Transpl 2016;22(11):1544-53.

17.

Benchimol EI, Walters TD, Kaufman M, et al. Assessment of knowledge in adolescents with inflammatory bowel disease using a novel transition tool. Inflamm Bowel Dis 2011;17(5):1131-7.

18.

Ödling M, Jonsson M, Janson C, et al. Lost in the transition from pediatric to adult healthcare? Experiences of young adults with severe asthma. J Asthma 2020;57(10):1119-27.

19.

Van Staa A. On Your Own Feet - three research projects. https://www.rotterdamuas.com/research/projects-and-publications/innovations-in-care/selfmanagement-and-participation/on-your-own-feet/the-project. Accessed 23 March 2023, 2023.

20.

Kinberg S, Verma T, Kaura D, et al. Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure. JPEN J Parenter Enteral Nutr 2023.

21.

van Rheenen PF, Aloi M, Biron IA, et al. European Crohn's and Colitis Organisation Topical Review on Transitional Care in Inflammatory Bowel Disease. J Crohns Colitis 2017;11(9):1032-38.

Abstract

Children and adolescents with chronic diseases requiring lifelong care face unique challenges that affect their daily lives and those of their families. Initially, these patients receive specialized care in pediatric facilities, where parents play a key role in treatment decisions. However, transitioning to adult healthcare facilities is inevitable, and this process, recognized as crucial years ago, involves moving adolescents with chronic conditions from child-centered to adult-oriented care. This transition can be complicated by varying age limits for pediatric care and the scarcity of adult care centers with specific expertise. The transition often requires cooperation between different centers or even countries due to patient mobility. The transition phase is critical, as it can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse. Beyond medical management, various factors influence the long-term prognosis of chronic conditions, making a well-organized transition program essential. While many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, there are frequent shortcomings in the process. This Mistakes In article will outline eight common mistakes made during the transition from pediatric to adult care, supported by literature and professional experience.

Topics

Primary Care

Citation

Jorge Amil-Dias, Hans Törnblom, Moriam Mustapha and Patrizia Burra. Mistakes in transitional care for children and young adults and how to avoid them. UEG Education 2023; 23: 22-25.

Published

2023

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Mistakes in abdominal distension and how to avoid them

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Summary

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Summary is not available for this content yet.

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8

Davidson LF, Doyle MH Health-care Transition: A Vital Part of Care, Growth, and Change for Pediatric Patients. Pediatr Rev 2021;42(12):684-93.

Leung Y, Heyman MB, Mahadevan U Transitioning the adolescent inflammatory bowel disease patient: guidelines for the adult and pediatric gastroenterologist. Inflamm.Bowel.Dis. 2011;17(10):2169-73.

Ludvigsson JF, Agreus L, Ciacci C, et al. Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut 2016;65(8):1242-51.

Mandato C, Vajro P Insights on Transition of Care-Related Deaths of Young Adults Who Were Recipients of Pediatric Liver Transplantation. J Pediatr Gastroenterol Nutr 2022;75(5):551-52.

Peixoto A, Reis EMA, Trindade E, et al. Protocol for the transition of pediatrics for adult medicine in celiac disease: a proposal approach. Eur J Gastroenterol Hepatol 2019;31(6):729-30.

White P, Schmidt A, Shorr J, et al. Integrating Young Adults into Adult Health Care - Six Core Elements of Health Care Transition (TM) 3.0. Washington, DC; 2020.

10.

11.

Escher JC Transition from pediatric to adult health care in inflammatory bowel disease. Dig Dis 2009;27(3):382-6.

12.

Philpott JR Transitional care in inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2011;7(1):26-32.

13.

Dellon ES, Jones PD, Martin NB, et al. Health-care transition from pediatric to adult-focused gastroenterology in patients with eosinophilic esophagitis. Dis Esophagus 2013;26(1):7-13.

14.

Gray WN, Holbrook E, Dykes D, et al. Improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator. J Pediatr Gastroenterol Nutr 2019;69(2):194-99.

15.

Ferrarese A, Germani G, Lazzaro S, et al. Short-term outcomes of paediatric liver transplant recipients after transition to Adult Healthcare Service. Liver Int 2018;38(7):1316-21.

16.

Hames A, Matcham F, Joshi D, et al. Liver transplantation and adolescence: The role of mental health. Liver Transpl 2016;22(11):1544-53.

17.

Benchimol EI, Walters TD, Kaufman M, et al. Assessment of knowledge in adolescents with inflammatory bowel disease using a novel transition tool. Inflamm Bowel Dis 2011;17(5):1131-7.

18.

Ödling M, Jonsson M, Janson C, et al. Lost in the transition from pediatric to adult healthcare? Experiences of young adults with severe asthma. J Asthma 2020;57(10):1119-27.

19.

20.

Kinberg S, Verma T, Kaura D, et al. Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure. JPEN J Parenter Enteral Nutr 2023.

21.

van Rheenen PF, Aloi M, Biron IA, et al. European Crohn's and Colitis Organisation Topical Review on Transitional Care in Inflammatory Bowel Disease. J Crohns Colitis 2017;11(9):1032-38.

Abstract

Abdominal distension and bloating are among the most frequently misunderstood complaints in gastroenterology. They are often used as interchangeable terms, a conceptual mistake that continues to drive diagnostic errors and ineffective treatment. According to Rome IV, bloating and distension may represent either a primary disorder of gut–brain interaction (DGBI) or occur as symptoms with other DGBIs, such as irritable bowel syndrome (IBS), functional dyspepsia (FD) or functional constipation (FC).

Topics

Neurogastroenterology & Motility

Citation

Barba E and Ezquerra-Durán A. Mistakes in abdominal distension and bloating and how to avoid them. UEG Education 2026; 26: 5-9.

Published

2026

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Abstract

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Hepatobiliary

Published

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Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8

Davidson LF, Doyle MH Health-care Transition: A Vital Part of Care, Growth, and Change for Pediatric Patients. Pediatr Rev 2021;42(12):684-93.

Leung Y, Heyman MB, Mahadevan U Transitioning the adolescent inflammatory bowel disease patient: guidelines for the adult and pediatric gastroenterologist. Inflamm.Bowel.Dis. 2011;17(10):2169-73.

Ludvigsson JF, Agreus L, Ciacci C, et al. Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut 2016;65(8):1242-51.

Mandato C, Vajro P Insights on Transition of Care-Related Deaths of Young Adults Who Were Recipients of Pediatric Liver Transplantation. J Pediatr Gastroenterol Nutr 2022;75(5):551-52.

Peixoto A, Reis EMA, Trindade E, et al. Protocol for the transition of pediatrics for adult medicine in celiac disease: a proposal approach. Eur J Gastroenterol Hepatol 2019;31(6):729-30.

White P, Schmidt A, Shorr J, et al. Integrating Young Adults into Adult Health Care - Six Core Elements of Health Care Transition (TM) 3.0. Washington, DC; 2020.

10.

11.

Escher JC Transition from pediatric to adult health care in inflammatory bowel disease. Dig Dis 2009;27(3):382-6.

12.

Philpott JR Transitional care in inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2011;7(1):26-32.

13.

Dellon ES, Jones PD, Martin NB, et al. Health-care transition from pediatric to adult-focused gastroenterology in patients with eosinophilic esophagitis. Dis Esophagus 2013;26(1):7-13.

14.

Gray WN, Holbrook E, Dykes D, et al. Improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator. J Pediatr Gastroenterol Nutr 2019;69(2):194-99.

15.

Ferrarese A, Germani G, Lazzaro S, et al. Short-term outcomes of paediatric liver transplant recipients after transition to Adult Healthcare Service. Liver Int 2018;38(7):1316-21.

16.

Hames A, Matcham F, Joshi D, et al. Liver transplantation and adolescence: The role of mental health. Liver Transpl 2016;22(11):1544-53.

17.

Benchimol EI, Walters TD, Kaufman M, et al. Assessment of knowledge in adolescents with inflammatory bowel disease using a novel transition tool. Inflamm Bowel Dis 2011;17(5):1131-7.

18.

Ödling M, Jonsson M, Janson C, et al. Lost in the transition from pediatric to adult healthcare? Experiences of young adults with severe asthma. J Asthma 2020;57(10):1119-27.

19.

20.

Kinberg S, Verma T, Kaura D, et al. Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure. JPEN J Parenter Enteral Nutr 2023.

21.

van Rheenen PF, Aloi M, Biron IA, et al. European Crohn's and Colitis Organisation Topical Review on Transitional Care in Inflammatory Bowel Disease. J Crohns Colitis 2017;11(9):1032-38.

Abstract

Malnutrition frequently occurs in patients who have chronic liver disease and worsens their prognosis. There are multiple causes of malnutrition in the context of cirrhosis: low dietary intake, malabsorption, metabolic alterations and modification of substrate utilisation. Sarcopenia, which is defined by loss of muscle mass and function, is a major component of malnutrition in patients with cirrhosis. Sarcopenia adversely affects the number and severity of complications, quality of life, the outcome of liver transplantation and the overall survival rate of patients with advanced liver disease. Physicians should be aware of the clinical and prognostic relevance of nutritional status, how to promptly recognise malnutrition and sarcopenia in patients with liver cirrhosis and how to appropriately manage these conditions. Here we discuss some mistakes that are frequently made regarding nutrition in chronic liver disease, and we provide evidence and experience-based approaches to avoid them.

Topics

Hepatobiliary Small Intestine & Nutrition

Citation

Merli M and Lapenna L. Mistakes in nutrition in chronic liver disease and how to avoid them. UEG Education 2021; 21: 23–25

Published

2021

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8

Davidson LF, Doyle MH Health-care Transition: A Vital Part of Care, Growth, and Change for Pediatric Patients. Pediatr Rev 2021;42(12):684-93.

Leung Y, Heyman MB, Mahadevan U Transitioning the adolescent inflammatory bowel disease patient: guidelines for the adult and pediatric gastroenterologist. Inflamm.Bowel.Dis. 2011;17(10):2169-73.

Ludvigsson JF, Agreus L, Ciacci C, et al. Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut 2016;65(8):1242-51.

Mandato C, Vajro P Insights on Transition of Care-Related Deaths of Young Adults Who Were Recipients of Pediatric Liver Transplantation. J Pediatr Gastroenterol Nutr 2022;75(5):551-52.

Peixoto A, Reis EMA, Trindade E, et al. Protocol for the transition of pediatrics for adult medicine in celiac disease: a proposal approach. Eur J Gastroenterol Hepatol 2019;31(6):729-30.

White P, Schmidt A, Shorr J, et al. Integrating Young Adults into Adult Health Care - Six Core Elements of Health Care Transition (TM) 3.0. Washington, DC; 2020.

10.

11.

Escher JC Transition from pediatric to adult health care in inflammatory bowel disease. Dig Dis 2009;27(3):382-6.

12.

Philpott JR Transitional care in inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2011;7(1):26-32.

13.

Dellon ES, Jones PD, Martin NB, et al. Health-care transition from pediatric to adult-focused gastroenterology in patients with eosinophilic esophagitis. Dis Esophagus 2013;26(1):7-13.

14.

Gray WN, Holbrook E, Dykes D, et al. Improving IBD Transition, Self-management, and Disease Outcomes With an In-clinic Transition Coordinator. J Pediatr Gastroenterol Nutr 2019;69(2):194-99.

15.

Ferrarese A, Germani G, Lazzaro S, et al. Short-term outcomes of paediatric liver transplant recipients after transition to Adult Healthcare Service. Liver Int 2018;38(7):1316-21.

16.

Hames A, Matcham F, Joshi D, et al. Liver transplantation and adolescence: The role of mental health. Liver Transpl 2016;22(11):1544-53.

17.

Benchimol EI, Walters TD, Kaufman M, et al. Assessment of knowledge in adolescents with inflammatory bowel disease using a novel transition tool. Inflamm Bowel Dis 2011;17(5):1131-7.

18.

Ödling M, Jonsson M, Janson C, et al. Lost in the transition from pediatric to adult healthcare? Experiences of young adults with severe asthma. J Asthma 2020;57(10):1119-27.

19.

20.

Kinberg S, Verma T, Kaura D, et al. Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure. JPEN J Parenter Enteral Nutr 2023.

21.

van Rheenen PF, Aloi M, Biron IA, et al. European Crohn's and Colitis Organisation Topical Review on Transitional Care in Inflammatory Bowel Disease. J Crohns Colitis 2017;11(9):1032-38.

Abstract

Peritoneal malignancies represent a complex and often misjudged clinical challenge. Historically synonymous with a terminal diagnosis, the advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) radically altered the prognosis for selected patients. However, progress has been jeopardised by a series of recurring and preventable errors in diagnosis, staging, and treatment selection. This article delineates the ten most critical pitfalls in managing peritoneal surface malignancies. For each pitfall, we provide evidence-based explanations, concrete clinical examples, and strategic recommendations for avoidance. We emphasise the pivotal role of early multidisciplinary discussion, precise imaging, and timely referral to high-volume expert centres to optimise patient outcomes and offer curative intent where previously there was none.

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