Moving house–moving medical teams: keeping control of my IBD

摘要

‘Come in Mr Smith, have a seat. It is very nice to meet you. I believe you are new to this region? Your GP has referred you to clinic with a brief letter saying you’ve had Crohn’s disease for 15 years and been under the care of Professor Brain at Ivory Tower University Hospital and are taking Infliximab and Azathioprine and need follow up in Inflammatory Bowel Disease (IBD) clinic? Could you help me fill in the details of your Crohn’s disease over the years?’ Many patients, relatives and most secondary care physicians managing patients with inflammatory bowel disease (IBD) will recognise this moment in a busy outpatient clinic whereby a new patient arrives in the clinic and the physician has suboptimal information from the outset. All continuity is lost; confidence is dented; and everyone feels frustrated by this situation despite often this being no single person’s ‘fault’. In short, transferring a patient between one institution and another is often not easy and, as a result, often not done well. However, to date, the evidence about the quality of care of patients transferring has been lacking, and the often-poor experience of transferring care, while well known and recognised, remains anecdotal. This is of course contrary to the growing recognition and guidance about the importance of transitional care between paediatric and adult care, and the poor health outcomes associated with either a lack or absence of transitional care provision.1