Impact of transfer from pediatric gastroenterology to adult gastroenterology care in eosinophilic esophagitis.

Given the chronic and progressive course of eosinophilic esophagitis (EoE), patients with pediatric-onset EoE will require uninterrupted gastroenterology (GI) care as they reach adulthood. Yet, the effectiveness of transferring and integrating EoE patients from pediatric GI (pGI) to adult GI (aGI) care has not been studied. To address this gap, we assessed loss to follow-up, duration from the last pGI to the first aGI encounters (clinic visit and EGD), and its impact on clinical course and medication non-adherence in EoE patients. We identified 58 EoE patients who initially received pGI care and were transferred to aGI between 2017 and 2023 within our institution's shared electronic medical record environment. Demographic, clinical, endoscopic, and histologic data were analyzed using descriptive statistics, survival analysis, Cox regression models, and paired comparisons. Loss to follow-up was 16%. The median duration from the last pGI clinic visit to the first aGI clinic visit was 299 days, and that for the last pGI EGD to the first aGI EGD was 730 days. A significantly higher odds of heartburn (McNemar P-value = 0.01) and higher medication non-adherence rates (7% vs. 26%) were noted in 49 patients who established care with the aGI. The endoscopic and histologic severity remained unchanged. In EoE patients, transferring from pGI to aGI care is associated with loss of follow-up, deterioration of symptoms, and medication non-adherence. There is a critical need to develop optimized protocols to ensure a seamless transfer of care for EoE patients.