A Klein1,2, F Olbert3,4, S Wintrich3, V Lutz-Wiegers3, G Horneff3,4. 1. Allgemeine Kinder- und Jugendmedizin, Asklepios Klinik Sankt Augustin GmbH, Arnold-Janssen-Str. 29, 53757, Sankt Augustin, Deutschland. ar.klein@asklepios.com. 2. Abteilung Pädiatrie, Medizinische Fakultät, Universität Köln, Köln, Deutschland. ar.klein@asklepios.com. 3. Allgemeine Kinder- und Jugendmedizin, Asklepios Klinik Sankt Augustin GmbH, Arnold-Janssen-Str. 29, 53757, Sankt Augustin, Deutschland. 4. Abteilung Pädiatrie, Medizinische Fakultät, Universität Köln, Köln, Deutschland.
Abstract
BACKGROUND: Transition is a joint effort of the young patients, their families and the attending pediatric and adult rheumatologists. The quality of the transitional process for patients with rheumatic diseases was retrospectively reviewed using a standardized questionnaire. Patients were transferred to rheumatologists for adult care through personal contact, if possible. METHODS: Inclusion criteria were: diagnosis of chronic inflammatory rheumatic joint disease or systemic rheumatic disease, duration of care for >2 years in the pediatric rheumatology center and ≥2 presentations at the age of 17-18 years. A telephone interview was performed using a standardized questionnaire on the type of care, medication, diagnosis, satisfaction with the care and the transition process. RESULTS: Of the 62 enrolled patients 50 (81%) had juvenile idiopathic arthritis (JIA). In total, 40 patients (65%) were seen by an adult rheumatologist on a regular basis. Reasons for discontinuation of medical care were mainly freedom of symptoms, lack of time and non-compliance. Before and after transition, 15 and 9 patients, respectively were treated with conventional disease-modifying antirheumatic drugs (DMARD) and 27 and 27, respectively with biologics. The subjective assessment of medical care in pediatric rheumatology was (mean ± SD) 9.3 ± 1.05, in adult rheumatology 7.6 ± 1.1 and the satisfaction with the transition process was 7.7 ± 2.1. Problem issues mentioned by some patients were lack of time with the rheumatologist and long waiting periods for appointments. DISCUSSION: Individual transfer of patients from pediatric to adult rheumatology care was associated with a high degree of satisfaction in this analysis. Change of diagnosis or an unexpected termination of rheumatology treatment was not detected.
BACKGROUND: Transition is a joint effort of the young patients, their families and the attending pediatric and adult rheumatologists. The quality of the transitional process for patients with rheumatic diseases was retrospectively reviewed using a standardized questionnaire. Patients were transferred to rheumatologists for adult care through personal contact, if possible. METHODS: Inclusion criteria were: diagnosis of chronic inflammatory rheumatic joint disease or systemic rheumatic disease, duration of care for >2 years in the pediatric rheumatology center and ≥2 presentations at the age of 17-18 years. A telephone interview was performed using a standardized questionnaire on the type of care, medication, diagnosis, satisfaction with the care and the transition process. RESULTS: Of the 62 enrolled patients 50 (81%) had juvenile idiopathic arthritis (JIA). In total, 40 patients (65%) were seen by an adult rheumatologist on a regular basis. Reasons for discontinuation of medical care were mainly freedom of symptoms, lack of time and non-compliance. Before and after transition, 15 and 9 patients, respectively were treated with conventional disease-modifying antirheumatic drugs (DMARD) and 27 and 27, respectively with biologics. The subjective assessment of medical care in pediatric rheumatology was (mean ± SD) 9.3 ± 1.05, in adult rheumatology 7.6 ± 1.1 and the satisfaction with the transition process was 7.7 ± 2.1. Problem issues mentioned by some patients were lack of time with the rheumatologist and long waiting periods for appointments. DISCUSSION: Individual transfer of patients from pediatric to adult rheumatology care was associated with a high degree of satisfaction in this analysis. Change of diagnosis or an unexpected termination of rheumatology treatment was not detected.
Authors: Jennifer Stinson; Sara Ahola Kohut; Lynn Spiegel; Meghan White; Navreet Gill; Gina Colbourne; Samantha Sigurdson; Karen Watanabe Duffy; Lori Tucker; Elizabeth Stringer; Beth Hazel; Jacqueline Hochman; John Reiss; Miriam Kaufman Journal: Int J Adolesc Med Health Date: 2014