Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2017; 23(29): 5405-5411
Published online Aug 7, 2017. doi: 10.3748/wjg.v23.i29.5405
Transition clinic attendance is associated with improved beliefs and attitudes toward medicine in patients with inflammatory bowel disease
Nancy Fu, Kevan Jacobson, Andrew Round, Kathi Evans, Hong Qian, Brian Bressler
Nancy Fu, Brian Bressler, Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
Kevan Jacobson, Kathi Evans, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada
Andrew Round, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Hong Qian, Centre of Health Evaluation and Outcome Sciences, Vancouver, BC V6Z 1Y6, Canada
Author contributions: Fu N and Bressler B designed the study; Fu N, Round A and Evans K distributed the questionnaires; Fu N and Round A collected data; Qian H analyzed data; Fu N, Jacobson K, Evans K and Bressler B interpreted and evaluated the data; Fu N drafted initial manuscript; Fu N, Jacobson K, Evans K and Bressler B critically revised the manuscript.
Institutional review board statement: The study was reviewed and approved by Research Ethics Board of University of British Columbia.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nancy Fu, MD, Division of Gastroenterology, Department of Medicine, University of British Columbia, 250 - 6091 Gilbert Road, Richmond, BC V7C 5L9, Canada. nfu@interchange.ubc.ca
Telephone: +1-604-2734447 Fax: +1-604-2734254
Received: January 8, 2017
Peer-review started: January 11, 2017
First decision: February 9, 2017
Revised: March 7, 2017
Accepted: May 19, 2017
Article in press: May 19, 2017
Published online: August 7, 2017
Abstract
AIM

To evaluated the differences in knowledge, adherence, attitudes, and beliefs about medicine in adolescents with inflammatory bowel disease (IBD) attending transition clinics.

METHODS

We prospectively enrolled patients from July 2012 to June 2013. All adolescents who attended a tertiary-centre-based dedicated IBD transition clinic were invited to participate. Adolescent controls were recruited from university-affiliated gastroenterology offices. Participants completed questionnaires about their disease and reported adherence to prescribed therapy. Beliefs in Medicine Questionnaire was used to evaluate patients’ attitudes and beliefs. Beliefs of medication overuse, harm, necessity and concerns were rated on a Likert scale. Based on necessity and concern ratings, attitudes were then characterized as accepting, ambivalent, skeptical and indifferent.

RESULTS

One hundred and twelve adolescents were included and 59 attended transition clinics. Self-reported adherence rates were poor, with only 67.4% and 56.8% of patients on any IBD medication were adherent in the transition and control groups, respectively. Adolescents in the transition cohort held significantly stronger beliefs that medications were necessary (P = 0.0035). Approximately 20% of adolescents in both cohorts had accepting attitudes toward their prescribed medicine. However, compared to the control group, adolescents in the transition cohort were less skeptical of (6.8% vs 20.8%) and more ambivalent (61% vs 34%) (OR = 0.15; 95%CI: 0.03-0.75; P = 0.02) to treatment.

CONCLUSION

Attendance at dedicated transition clinics was associated with differences in attitudes in adolescents with IBD.

Keywords: Inflammatory bowel disease, Adolescents, Transition, Beliefs, Knowledge, Attitudes

Core tip: Inflammatory bowel disease (IBD) transition clinics may improve care of adolescents. Comparing ones attended transition clinics to those didn’t, this study assessed adolescents with IBD’s self-reported adherence to prescribed therapy and evaluated their attitudes and beliefs using Beliefs in Medicine Questionnaire. Self-reported adherence rates were poor in both cohorts. Adolescents in the transition cohort held significantly stronger beliefs that medications were necessary. They were also less skeptical of and more ambivalent to prescribed treatments. Attendance at dedicated transition clinics was associated with differences in attitudes in adolescents with IBD.