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.
