The importance of transition from pediatric to adult rheumatology care in juvenile idiopathic arthritis

Expert Rev Clin Immunol. 2021 Feb;17(2):155-161. doi: 10.1080/1744666X.2020.1865157. Epub 2021 Jan 22.

Abstract

Introduction: Juvenile idiopathic arthritis (JIA) is the most common rheumatic inflammatory condition in childhood. The long-term morbidity, mortality, and quality of life have improved with the earlier use of disease-modifying drugs (DMARDs) and the availability of biology disease-modifying drugs (bDMARDs). Despite the improvement of treatment, around 50% of the patients reach adulthood with articular and/or extra articular disease activity. A careful planned transition from pediatric to adult care is necessary to reduce the loss of follow-up that is associated with stopping medications, flares, and disability due to untreated arthritis or uveitis.Areas covered: This narrative review provides an overview of the importance of transition in JIA Articles were selected from Pubmed searches.Expert opinion: JIA patients, family, and healthcare workers have to be trained to provide an effective transition plan, based on local and national policies. Important aspects such as expectations, maturation, disease characteristics, disease activity, adherence, disability, and psychological aspects among others have to be considered and addressed during the transition phase to improve self-esteem, self-assurance, and quality of life.

Keywords: Flare; SLE; Transition of care; juvenile idiopathic arthritis; long-term outcome; risk factors; young adult clinic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Juvenile* / psychology
  • Arthritis, Juvenile* / therapy
  • Child
  • Delivery of Health Care / organization & administration
  • Delivery of Health Care / standards
  • Humans
  • Quality of Life
  • Transition to Adult Care* / organization & administration
  • Transition to Adult Care* / standards

Substances

  • Antirheumatic Agents