SAN DIEGO — Starting college can be tough for anyone, but students with inflammatory bowel disease have a greater risk for poor adjustment to college life, according to results of a prospective study presented at Digestive Disease Week.
Angela Pham, MD, of the division of gastroenterology at University of Florida, said the transition from pediatric to adult care in IBD is often poorly managed and comes at difficult point of life for patients, making them vulnerable to poorer outcomes.
“Transition usually occurs during the college years, and little is known about the college experience for youth living with chronic illness like IBD,” Pham said in her presentation. “Understanding why there are barriers to IBD students’ adjustment to college helps optimize the care of adolescent IBD patients.”
Researchers performed a prospective study to understand how these patients manage their disease and how it impacts their life in college. They used a cohort of 135 individuals, including 59 patients with IBD and 76 controls.
Participants completed four surveys — college adjustment (SACQ), transition readiness (TRAQ), self-efficacy (IBDSES) and disease-specific quality of life (IBDQ) — to assess their transition to college, and researchers used the Harvey-Bradshaw Index and Patient Simple Clinical Colitis Activity Index to assess disease activity.
Although the cases and controls had similar SACQ scores, patients with IBD were more likely to have interruptions to their education (39% vs. 12%, P = .0005), attend community college (14% vs. 7%, P = .009), live at home with family (24% vs. 5%, P = .0011) and take out study loans (36% vs. 14%, P = .02) than control participants. They were also less likely to move out of town for college (38% vs. 70%, P = .0002).
When researchers looked at TRAQ scores, they found that students with IBD had better health management skills than their healthy peers (P = .0006) and were better able to track their health issues and manage their daily activities.
Pham said one of the biggest predictors of poor college adjustment was age at diagnosis. Patients who were older at their diagnosis had a harder time adjusting to college life, with each added year in age at diagnosis resulting in a 0.1 decrease to SACQ score. Male students had a greater risk for poor transition to adult care.
Pham said the currently available scores do not appear to accurately reveal the concerns that are most important to students with chronic diseases.
“When we delved deeper, we realized that our IBD students may score well in the SACQ, but their college experiences were far from ideal,” she said. “Newly diagnosed students and male students, especially, merit additional resources and attention early on to ensure a smooth transition experience and a successful college career, and ultimately, a successful and healthy life.” – by Alex Young
Pham AK, et al. Abstract 205. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Pham reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.