Poster Presentation International Celiac Disease Symposium 2026

Transition Readiness from Pediatrics to Adult Care and Contributing Factors in Adolescents with Celiac Disease: A Prospective Study (#323)

Kati Kuusela 1 2 , Marleena Repo 1 3 4 , Marko Kalliomäki 5 , Claire Jansson-Knodell 6 , Sara Koskimaa 1 3 , Anne-Mari Keto-Oja 7 , Antti Sotka 8 , Kirsi Nuolivirta 7 , Pekka Arikoski 9 , Katri Kaukinen 1 , Kalle Kurppa 1 3 4 10 , Laura Kivelä 1 2 4
  1. Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
  2. Children's Hospital, Helsinki University Hospital, Helsinki, Finland
  3. Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
  4. Department of Pediatrics, Tampere University Hospital, The Wellbeing Services County of Pirkanmaa, Tampere, Finland
  5. Department of Pediatrics and Adolescent Medicine, Turku University Hospital, The Wellbeing Services County of Southwest Finland, Turku, Finland
  6. Celiac Disease Program, Department of Gastroenterology, Hepatology, and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
  7. Department of Pediatrics and Adolescent Medicine, Seinäjoki Central Hospital, The Wellbeing Services County of Ostrobothnia, Seinäjoki, Finland
  8. Department of Paediatrics, South Karelia Central Hospital, The Wellbeing Services County of South Karelia, Lappeenranta, Finland
  9. Kuopio Paediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, The Wellbeing Services of North Savo, Kuopio, Finland
  10. The University Consortium of Seinäjoki, Seinäjoki, Finland

Objectives and Study: Successful transition from pediatric to adult care is needed to ensure favorable treatment outcomes. Evidence on adolescents’ readiness for transition and associated factors in celiac disease (CeD) is limited.

Methods: Adolescents aged 13–19 with CeD were prospectively recruited to complete structured questionnaires and undergo testing of CeD serology. Diagnostic data was retrieved from medical records. Parents were also invited to answer questionnaires. Diagnostic characteristics and treatment outcomes were compared between those who did and who did not consider themselves ready for transition. Am I ON TRAC? questionnaire was used to evaluate the different aspects of transition readiness. 

Results: Of 63 participants, 32 (51%) reported being ready for transition and 31 (49%) being partly (n=24) or not ready (n=7). Those ready for transition were older (median 16.5 vs 15.1 years, p<0.001), and less frequently experienced anxiety (22% vs 61%, p=0.004) and daily life restrictions (16% vs 39%, p=0.039) due to the gluten-free diet (GFD). Their knowledge scores in the Am I ON TRAC? questionnaire were higher (median 34 vs 27, p=0.011). No significant differences were observed in sex (females 75%), age at diagnosis, diagnostic approach, family history of CeD, GFD adherence, self-perceived health, or CeD serology at follow-up. Of parents, 63% considered their child ready for transition. Among adolescents who felt ready, 80% of parents agreed, whereas among those who did not feel ready, 50% agreed (p=0.037). Both adolescents and parents identified 18 years (IQR 16, 18) as the optimal age for transition of care.

Conclusions: Only half of the adolescents reported being ready for transition. The views of adolescents and their caregivers did not always align. Physician awareness of associated factors may help guide resources to support a successful transition from pediatric to adult care.