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UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care
  1. Alenka J Brooks1,*,
  2. Philip J Smith2,*,
  3. Richard Cohen3,
  4. Paul Collins4,
  5. Andrew Douds5,
  6. Valda Forbes6,
  7. Daniel R Gaya7,
  8. Brian T Johnston8,
  9. Patrick J McKiernan9,
  10. Charles D Murray2,
  11. Shaji Sebastian10,
  12. Monica Smith11,
  13. Lisa Whitley12,
  14. Lesley Williams13,
  15. Richard K Russell14,
  16. Sara A McCartney15,
  17. James O Lindsay16,17
  1. 1Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK
  2. 2Centre for Gastroenterology and Hepatology, Royal Free Hospital, London, UK
  3. 3Department of Surgery, UCLH, London, UK
  4. 4Royal Liverpool University Hospital, Liverpool, UK
  5. 5Queen Elizabeth Hospital NHS Foundation Trust, University of East Anglia, King's Lynn, Norfolk, UK
  6. 6Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
  7. 7Glasgow Royal Infirmary, Glasgow, UK
  8. 8Deparment of Gastroenterology, Royal Victoria Hospital, Belfast, UK
  9. 9Liver Unit, Birmingham Children's Hospital, Birmingham, UK
  10. 10NIHR LCRN (Y&H) Gastroenterology Speciality Co-Lead, Hull & East Yorkshire NHS Trust, Hull, UK
  11. 11Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, UK
  12. 12GI Services Division, University College London Hospital, London, UK
  13. 13London, UK
  14. 14Department of Paediatric Gastroenterology, The Royal Hospital for Children Glasgow, Glasgow, UK
  15. 15Department of Gastroenterology, UCLH, London, UK
  16. 16Bart's Health NHS Trust, The Royal London Hospital, London, UK
  17. 17Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK
  1. Correspondence to Dr James O Lindsay, Bart's Health NHS Trust, The Royal London Hospital, London E1 1BB, UK; James.Lindsay{at}


The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section. Electronic searches for English-language articles were performed with keywords relating to digestive system diseases and transition to adult care in the Medline (via Ovid), PsycInfo (via Ovid), Web of Science and CINAHL databases for studies published from 1980 to September 2014. The quality of evidence and grading of recommendations was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The limited number of studies in gastroenterology and hepatology required the addition of relevant studies from other chronic diseases to be included.

These guidelines deal specifically with the transition of AYP living with a diagnosis of chronic digestive disease and/or liver disease from paediatric to adult healthcare under the following headings;

1. Patient populations involved in AYP transition

2. Risks of failing transition or poor transition

3. Models of AYP transition

4. Patient and carer/parent perspective in AYP transition

5. Surgical perspective


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  • *Brooks and Smith are joint first authors.

  • Twitter Follow Alenka Brooks @alenkabrooks and Philip Smith @drphilipjsmith

  • Contributors PJS, AJB, SAM and JOL wrote and revised the manuscript, devised figures 1, 2 and tables 2, 3, and were part of the working group that developed the recommendations. RC, PC, AD, VF, DRG, RKR, SS, LWh, MS, BTJ, PJM, CDM and LWi also contributed to the manuscript and helped develop the recommendations. Table 1 was developed by RKR, AD and PJM.

  • Funding This guideline was commissioned by Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Adolescent & Young Person Section of the BSG.

  • Competing interests JOL was a member of Clinical Trials Research Group of the BSG 2014–2016, Chair of Education Committee ECCO 2014–2016, Editorial Board CCUK 2014–2016. RKR was a Medical Advisor of CCUK from 2013 to 2016; and LW was a Nurse Reader for information leaflets for CCUK from 2012 to 2016.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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