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Differential effect of a patient-education transition intervention in adolescents with IBD vs. diabetes

  • Original Article
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Abstract

Patient education programs (PEPs) to improve disease management are part of standard and regular treatment in adolescents with diabetes. In Germany, youth with inflammatory bowel disease (IBD) receive individual counseling but not PEPs in group settings. Generic PEPs have been developed in order to improve transition from child-centered to adolescent health services. The aim of the study was to investigate the effects of a transition-oriented PEP on quality of life (QoL) and self-management in young patients with IBD (PEP naive), compared to patients with diabetes (familiar with PEPs). A 2-day transition workshop was oriented at improving psychosocial skills and addressed both generic as well as specific aspects of the condition. A controlled trial on the outcomes of a generic transition-oriented PEP was conducted in 14- to 20-year-old patients with IBD (n = 99) and diabetes (n = 153). Transition competence and QoL were assessed at baseline and 6-month follow-up. Results show that the intervention lead to a significant increase in QoL only in patients with IBD. The PEP significantly improved transition competence in both groups, however to a higher extent in subjects with IBD.

Conclusion: Transition-oriented PEPs can have differential effects in different patient groups. However, this needs further longitudinal investigations.

What is Known:

• To date, evidence has accumulated concerning the effectiveness of patient education programs (PEPs) in pediatric health care for chronic conditions such as type 1 diabetes, asthma, atopic dermatitis, or obesity but is less documented in inflammatory bowel disease (IBD). In particular, PEPs in the transition period have not been investigated in youth with IBD.

• The current study focuses on evaluating a PEP for transition preparation and management designed to be generically used across different chronic conditions since many aspects of managing chronic conditions share commonalities across conditions. The 2-day workshop included condition-specific modules adapted to the specific medical needs but was otherwise similar in quality and organization among different conditions.

What is New:

• The transition-oriented PEP was effective in enhancing self-management and transition management skills in both patients with IBD and diabetes; however, effects were higher in youth with IBD. A significant impact of the intervention on patients’ QoL compared to the control group was only identified in youth with IBD.

• We recommend that patients with IBD have access to PEP as a standard treatment as well as to a transition program during the course of illness.

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Abbreviations

DCGM short-form:

DISABKIDS Chronic Generic Measure short-form

IBD:

Inflammatory bowel disease

ICD-10:

International Classification of Diseases, 10th Edition

PEP:

Patient education program

QoL:

Quality of life

TCS:

Transition competence scale

RMCVA:

Repeated measurement covariance analysis

SPSS:

Statistical Package for the Social Sciences

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Funding

The study was funded by the Federal Ministry of Education and Research (BMBF, Grant Nr. 01 6x1005).

Author information

Authors and Affiliations

  1. Department Health and Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University of Greifswald, Robert-Blum-Str. 13, 17487, Greifswald, Germany

    Silke Schmidt, Henriette Markwart & Holger Muehlan

  2. Department of Child and Adolescent Medicine, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Franziska Bomba, Martina Kohl, Ingo Menrath & Ute Thyen

  3. Department of Child and Adolescent Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany

    Annette Findeisen

Authors
  1. Silke Schmidt
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  2. Henriette Markwart
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  3. Franziska Bomba
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  4. Holger Muehlan
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  5. Annette Findeisen
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  8. Ute Thyen
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Contributions

Professor Schmidt has planned the study, supervised and analyzed the study, written the paper and reviewed the paper. Ms. Markwart and Dr. Muehlan have carried out analysis, interpreted analyses and reviewed the paper. Ms. Bomba has carried out the study in one of the study centers and contributed to writing the paper. Dr. Findeisen and Dr. Kohl have carried out the study from the clinical point of view and have reviewed the paper. Dr. Menrath has carried out the study in the clinical center and contributed to reviewing the paper. Professor Thyen has planned the study, supervised the study and reviewed the paper.

Corresponding author

Correspondence to Silke Schmidt.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for the study was obtained by the Institutional Review Board at the University Medical Center of Greifswald.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Peter de Winter

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Schmidt, S., Markwart, H., Bomba, F. et al. Differential effect of a patient-education transition intervention in adolescents with IBD vs. diabetes. Eur J Pediatr 177, 497–505 (2018). https://doi.org/10.1007/s00431-017-3080-z

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  • DOI: https://doi.org/10.1007/s00431-017-3080-z

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