Chinese General Practice ›› 2026, Vol. 29 ›› Issue (25): 3704-3712.DOI: 10.12114/j.issn.1007-9572.2025.0230

• Evidence-based Medicine • Previous Articles    

Summary of the Best Evidence for Managing the Transition of Adolescent Inflammatory Bowel Disease Patients to Adult Medical Care

  

  1. 1. Department of Nursing, Tenth People's Hospital of Tongji University, Shanghai 200072, China
    2. School of Medicine, Tongji University, Shanghai 200070, China
    3. School of Nursing, Anhui University of Chinese Medicine, Hefei 230012, China
  • Received:2025-10-20 Revised:2026-04-08 Published:2026-09-05 Online:2026-08-11
  • Contact: CHEN Yamei

青少年炎症性肠病患者向成人医疗过渡管理的最佳证据总结

  

  1. 1.200072 上海市,同济大学附属第十人民医院护理部
    2.200070 上海市,同济大学医学院
    3.230012 安徽省合肥市,安徽中医药大学护理学院
  • 通讯作者: 陈亚梅
  • 作者简介:

    作者贡献:

    王蓉负责文章的构思与设计及论文撰写;王蓉、邸允政负责文献检索、筛选及证据提取与汇总;徐涯鑫、徐军负责文献质量评价及证据分级;姚亭负责表格的编辑、整理及论文初稿的撰写;陈亚梅负责论文修订、文章的质量控制及审校,对文章整体负责。

  • 基金资助:
    国家自然科学基金资助项目(72274135)

Abstract:

Background

As the prevalence of inflammatory bowel disease (IBD) rises in children and adolescents, the management of the transition from adolescent to adult healthcare in this population is becoming increasingly important, and poorly managed transitions will have a profound impact on the quality of patients' future survival. There has been a gradual increase in relevant studies at home and abroad; however, the quality is variable, and systematic summarization is lacking.

Objective

To systematically summarise the best evidence on the transition of IBD patients from pediatric to adult healthcare systems using a scientific evidence-based approach, and to provide reliable evidence and theoretical guidance for clinical exploration of protocol construction and intervention practices for the transition management of adolescent IBD patients.

Methods

According to the "6S" pyramid model of evidence resources, a top-down search was conducted across computerized decision support systems, guideline websites, professional academic websites, and domestic and international databases, including BMJ Best Practice, UpToDate Clinical Advisor, JBI Evidence-based Healthcare Database, the website of the Registered Nurses' Association of Ontario (Canada), the website of the National Institute for Health and Care Excellence (UK), the Scottish Intercollegiate Guidelines Network, the Guidelines International Network, the New Zealand Guidelines Group, the World Gastroenterology Organisation, the International Practice Guidelines Registry Platform, Medlive, the American Academy of Pediatrics, the Crohn's & Colitis Foundation (USA), PubMed, Cochrane Library, Web of Science, CINAHL, Embase, Medline, OVID, the China Biology Medicine Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP Database. The search focused on clinical decision-making tools, guidelines, expert consensus, evidence summaries, best practices, and systematic reviews related to transition and transfer, transition readiness, and transition management in pediatric or adolescent patients with inflammatory bowel disease. The search timeframe spanned from the inception of each database to April 2025. Two researchers independently performed quality assessment, evidence extraction, synthesis, and grading of the included literature.

Results

A total of 17 articles were included, comprising 2 clinical decision-making tools, 6 guidelines, 3 expert consensuses, and 6 systematic reviews. The quality of all included studies was rated as moderate or higher. Thirty pieces of evidence were synthesized across seven domains: transition goals, transition timing, multidisciplinary team preparation, transition readiness assessment, patient transition readiness, family collaboration and support, and environmental and policy support. Among these, 23 were strong recommendations, and 7 were weak recommendations.

Conclusion

The best evidence summarised in this study for the transition of patients with inflammatory bowel disease from paediatrics to adults is comprehensive, scientific, and practical, and can inform practice norms for the transition of patients with inflammatory bowel disease. It also suggests that pediatric and adult healthcare providers need to conduct a comprehensive analysis of transitioning patients with inflammatory bowel disease and their families, develop targeted transition intervention programs and interventions based on patient needs, and facilitate the transition of patients from pediatric to adult healthcare to improve their transition experience and health outcomes.

Key words: Inflammatory bowel disease, Adolescents, Transition, Management, Evidence summary, Evidence-based nursing

摘要:

背景

随着炎症性肠病在儿童和青少年中发病率的上升,该人群从青少年向成人医疗的过渡管理愈发重要,过渡管理不当将对患者未来的生存质量产生深远影响。目前,国内外相关研究逐渐增多,但质量参差不齐且缺乏系统总结。

目的

采用科学的循证方法系统总结炎症性肠病患者从儿科向成人医疗保健系统过渡的最佳证据,为临床探索青少年炎症性肠病患者过渡管理的方案构建和干预实践提供可靠的证据和理论指导。

方法

根据"6S"证据资源金字塔模型,自上而下检索包括BMJ Best Practice、UpToDate临床顾问、JBI循证卫生保健中心数据库、加拿大安大略省注册护士协会网站、英国国家卫生与临床优化研究所网站、苏格兰校际指南网、国际指南协作网、新西兰指南协作组、世界胃肠病组织网、国际实践指南注册与透明化平台、医脉通、美国儿童学、美国克罗恩病和结肠炎基金会、PubMed、Cochrane Library、Web of Science、CINAHL、Embase、Medline、OVID、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普网在内的计算机决策系统、指南网站、专业学术网站及国内外数据库中有关儿童或青少年炎症性肠病患者过渡和转移、过渡准备和过渡管理的临床决策、指南、专家共识、证据总结、最佳实践、系统评价。检索时限为建库至2025年4月。由2名研究者对纳入文献进行质量评价、证据提取和汇总与分级。

结果

共纳入17篇文献,其中临床决策2篇,指南6篇,专家共识3篇,系统评价6篇。纳入的文献经评价质量均为中等及以上。从过渡的目标、过渡的时机、多学科团队准备、过渡准备评估、患者过渡准备、家庭合作支持、环境和政策支持7个方面汇总了30条证据,其中强推荐23条,弱推荐7条。

结论

本研究总结的炎症性肠病患者从儿科向成人医疗过渡的最佳证据具有一定的全面性、科学性和实用性,可以为青少年炎症性肠病患者过渡提供实践规范的依据。同时提示,儿科和成人医疗服务提供者需对过渡期的炎症性肠病患者及其家庭进行全面分析,根据患者需求有针对性地发展过渡干预方案并进行干预,促进患者从儿科向成人医疗过渡,改善其过渡体验和健康结局。

关键词: 炎症性肠病, 青少年, 过渡, 管理, 证据总结, 循证护理学

CLC Number: