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@MondayNightIBD 4/#MondayNightIBD
19M presents to GI clinic as a new patient w his grandma. He was dx’d with pan-UC at 12 & has been on adalimumab with reported 6 BMs/day, occasionally with 🩸, but reports this is “his normal”. He has not had any labs, endoscopy, or imaging done in the past…
19M presents to GI clinic as a new patient w his grandma. He was dx’d with pan-UC at 12 & has been on adalimumab with reported 6 BMs/day, occasionally with 🩸, but reports this is “his normal”. He has not had any labs, endoscopy, or imaging done in the past…
@MondayNightIBD 5/#MondayNightIBD
year since moving. He is running low on adalimumab so his grandma scheduled this appointment for him to get refills.
This patient has transitioned to an adult provider, but is early in his transition process. 👀the Transitional care (TC) in IBD🧵👇to learn more
year since moving. He is running low on adalimumab so his grandma scheduled this appointment for him to get refills.
This patient has transitioned to an adult provider, but is early in his transition process. 👀the Transitional care (TC) in IBD🧵👇to learn more
@MondayNightIBD 6/#MondayNightIBD
TC is a PROCESS that occurs throughout adolescence. It is not a singular event. During this process, patients are:
✅ Developing an identity
✅ Becoming 💵 independent
✅ Acquiring skills needed for adult relationships and roles including abstract reasoning
TC is a PROCESS that occurs throughout adolescence. It is not a singular event. During this process, patients are:
✅ Developing an identity
✅ Becoming 💵 independent
✅ Acquiring skills needed for adult relationships and roles including abstract reasoning
@MondayNightIBD 7/ #MondayNightIBD
TC is important in IBD
🚨The peri-transitional period is associated w
⬆️ flares
⬆️ surgery
⬆️ radiation/imaging
⬆️ hospitalization
⬆️ ED visits
⬆️ endoscopy
⬇️ adherence
⬇️ sexual satisfaction
⬇️ patient satisfaction
TC is important in IBD
🚨The peri-transitional period is associated w
⬆️ flares
⬆️ surgery
⬆️ radiation/imaging
⬆️ hospitalization
⬆️ ED visits
⬆️ endoscopy
⬇️ adherence
⬇️ sexual satisfaction
⬇️ patient satisfaction
@MondayNightIBD The goals of TC are to improve self-management, improve understanding of the medical system, and help patients reach their fullest potential. There are 6 core elements to TC according to gottransition.org which has many additional resources and tools for TC. 
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 10/ #MondayNightIBD
Assessing skills is critical to uncover gaps in self-management needing to be addressed.
Even when medical knowledge is considered adequate, adherence is still less than satisfactory. There are many important questions to consider in addition to the basics
Assessing skills is critical to uncover gaps in self-management needing to be addressed.
Even when medical knowledge is considered adequate, adherence is still less than satisfactory. There are many important questions to consider in addition to the basics
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 11/ #MondayNightIBD
❓Who helps with medications, appointments, etc
❓How do you get refills?
❓What medications do you take; why/when/how do you take them?
❓When do you go to the ED vs call/message the office?
❓What is your insurance through and when does it expire?
❓Who helps with medications, appointments, etc
❓How do you get refills?
❓What medications do you take; why/when/how do you take them?
❓When do you go to the ED vs call/message the office?
❓What is your insurance through and when does it expire?
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 12/#MondayNightIBD
Adult providers can feel that TC is beyond their control and expect patients to come with a care summary and basic knowledge of their disease. Patients generally fear the unknown and that their new doctors won’t really know them beyond their disease
Adult providers can feel that TC is beyond their control and expect patients to come with a care summary and basic knowledge of their disease. Patients generally fear the unknown and that their new doctors won’t really know them beyond their disease
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 13/ #MondayNightIBD
Patients need to trust their providers & there is limited time to establish this trust with a new patient, thus it is important to get to know them on a personal level. Some questions to consider asking…
Patients need to trust their providers & there is limited time to establish this trust with a new patient, thus it is important to get to know them on a personal level. Some questions to consider asking…
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 14/#MondayNightIBD
💬What are your life goals?
💬Any plans to start a family?
💬What do you spend your free time doing?
💬Do you work &/or go to school? Where?
💬What is your living arrangement? Does it change throughout the year?
💬How does your disease affect your life?
💬What are your life goals?
💬Any plans to start a family?
💬What do you spend your free time doing?
💬Do you work &/or go to school? Where?
💬What is your living arrangement? Does it change throughout the year?
💬How does your disease affect your life?
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 15/ #MondayNightIBD
Adolescents with IBD have ⬆️ rates of depression, anxiety, eating disorders as well as altered self-image, social isolation, family & school dysfunction. Involving mental health providers is critical to improve their overall health and well being.
Adolescents with IBD have ⬆️ rates of depression, anxiety, eating disorders as well as altered self-image, social isolation, family & school dysfunction. Involving mental health providers is critical to improve their overall health and well being.
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat 16/#MondayNightIBD
Utilize technology to empower patients! There are many online resources & phone apps - from tracking symptoms, keeping medical records, connecting w other patients, all the way to finding the nearest public restroom!
Utilize technology to empower patients! There are many online resources & phone apps - from tracking symptoms, keeping medical records, connecting w other patients, all the way to finding the nearest public restroom!
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat @DrJSilverman @hilarykmichel @Gastro4Kids @BenjamminGold @rafeeq_rm @JKurowskiMD @GI_and_BowtieMD @DrChrisMoran @ToshiYodoshi @laurenjarchinmd 17/#MondayNightIBD
Structured TC programs can be impactful! They can also be resource intensive & not reimbursed well, but have been shown to:
⬆️ satisfaction & well being
⬆️ adherence
⬆️ medication knowledge
No ⬆️ $/patient
⬇️ ED visits & hospitalizations
⬇️ steroids
Structured TC programs can be impactful! They can also be resource intensive & not reimbursed well, but have been shown to:
⬆️ satisfaction & well being
⬆️ adherence
⬆️ medication knowledge
No ⬆️ $/patient
⬇️ ED visits & hospitalizations
⬇️ steroids
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat @DrJSilverman @hilarykmichel @Gastro4Kids @BenjamminGold @rafeeq_rm @JKurowskiMD @GI_and_BowtieMD @DrChrisMoran @ToshiYodoshi @laurenjarchinmd 18/#MondayNightIBD
Take🏠points
🔑TC is complicated and requires a multifaceted + holistic approach
🔑Use TC tools and resources to make the process more efficient/effective
🔑Use mental health providers, social work, case management, & support groups
🔑Empower your patients
Take🏠points
🔑TC is complicated and requires a multifaceted + holistic approach
🔑Use TC tools and resources to make the process more efficient/effective
🔑Use mental health providers, social work, case management, & support groups
🔑Empower your patients
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat @DrJSilverman @hilarykmichel @Gastro4Kids @BenjamminGold @rafeeq_rm @JKurowskiMD @GI_and_BowtieMD @DrChrisMoran @ToshiYodoshi @laurenjarchinmd 19/#MondayNightIBD
#PostConvo #IBDPoll 1️⃣
🆓#CME👉🏼bit.ly/MNIBDPost_Bill…
In a recent survey, what percentage of adolescent and young adult (AYA) were ready to transition from #PedsGI to #AdultGI for their #IBD care?
doi.org/10.1016/j.jped…
#PostConvo #IBDPoll 1️⃣
🆓#CME👉🏼bit.ly/MNIBDPost_Bill…
In a recent survey, what percentage of adolescent and young adult (AYA) were ready to transition from #PedsGI to #AdultGI for their #IBD care?
doi.org/10.1016/j.jped…
@MondayNightIBD @DrRosenIBD @pedsIBDdoc @DiscoverIBD @SeowCynthia @marc_cram @drlauriekeefer @snehadave98 @Bealoquebea @JessPhilpottMD @temarahajjat @DrJSilverman @hilarykmichel @Gastro4Kids @BenjamminGold @rafeeq_rm @JKurowskiMD @GI_and_BowtieMD @DrChrisMoran @ToshiYodoshi @laurenjarchinmd 20/#MondayNightIBD
#PostConvo #IBDPoll 2️⃣
CME👉🏼bit.ly/MNIBDPost_Bill…
U are seeing an adolescent w #IBD (been following for 5yrs); he's leaving for college & needs to transition care to adult GI.
Which is NOT a core element of TC from PedsGI to adult GI for AYA w IBD?
#PostConvo #IBDPoll 2️⃣
CME👉🏼bit.ly/MNIBDPost_Bill…
U are seeing an adolescent w #IBD (been following for 5yrs); he's leaving for college & needs to transition care to adult GI.
Which is NOT a core element of TC from PedsGI to adult GI for AYA w IBD?
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