Transitioning patients with juvenile idiopathic arthritis to adult care: the Nordic experience

Katriina Mikola*, Katariina Rebane, Ellen Dalen Arnstad, Lillemor Berntson, Anders Fasth, Mia Glerup, Troels Herlin, Hannu Kautiainen, Susan Nielsen, Ellen Nordal, Suvi Peltoniemi, Marite Rygg, Veronika Rypdal, Marek Zak, Kristiina Aalto

*Corresponding author for this work

Abstract

BACKGROUND: With juvenile idiopathic arthritis (JIA), there are several protocols and practices used worldwide for the transition from paediatric to adult care. In this study, we examined the transferral rates and disease activity after transition, as well as the disease- and health-related outcomes. We also introduce the transition practices employed in the Nordic countries.

METHODS: The study population comprised 408 participants with a disease onset from 1997 to 2000 who attended an 18-year follow-up visit in this population-based Nordic JIA cohort study. The patients were retrospectively divided into three subgroups: Patients transferred directly from paediatric care to adult rheumatology care, patients referred there later, and patients never transferred during the 18-year follow-up period.

RESULTS: One hundred and sixty-three (40%) JIA patients had been directly transferred to an adult clinic. The cumulative transition rate was 52%, but there were significant differences between the participating centres. Fifty patients had later been referred to an adult clinic. Among the 195 patients who had never been transferred, 39% were found to have disease activity at the study visit.

CONCLUSION: This study highlights the need to reconsider transition practices to avoid our undesirable finding of patients with disease activity in JIA, but no appropriate health care follow-up.

Original languageEnglish
Article number84
JournalPediatric Rheumatology Online Journal
Volume20
Issue number1
Pages (from-to)1-9
Number of pages9
ISSN1546-0096
DOIs
Publication statusPublished - 1 Oct 2022

Keywords

  • Adult
  • Antirheumatic Agents/therapeutic use
  • Arthritis, Juvenile/drug therapy
  • Child
  • Cohort Studies
  • Humans
  • Retrospective Studies
  • Transition to Adult Care

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