Pediatric rheumatology: addressing the transition to adult-orientated health care

Sara Sabbagh,1,2 Tova Ronis,1,3 Patience H White3–5 1Department of Rheumatology, Children’s National Health System, Washington DC, USA; 2National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD USA; 3Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington DC, USA; 4Department of Rheumatology, George Washington University School of Medicine and Health Sciences, Washington DC, USA; 5Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington DC, USA Abstract: The transition from pediatric to adult health care is often a challenging process due to multiple interwoven complexities, especially for children with chronic medical conditions. Health care transition (HCT) is a process of moving from a pediatric to an adult model of health care with or without a transfer to a new clinician. This paper focuses on what is known about HCT for youth and young adults (Y/YA) with rheumatic diseases within a larger context of HCT recommendations. HCT barriers for youth, families, and providers and current evidence for a structured HCT processes are reviewed. Practical advice is offered on how to approach transition for Y/YA, what tools are available to assist in a successful transition process, and what are the areas of future research that are needed to improve the HCT evidence base. Keywords: health care transition, pediatric rheumatology, special health care needs, transition, transition readiness assessmen