Is there a benefit to having a transition period in which a patient continues following with their previous pediatric rheumatologist while establishing care with a new adult rheumatologist?

Several pediatric to adult care models exist. Some models involve transition clinics in which adult and pediatric providers are both present and care may overlap between the two providers. Others are primarily focused on the pediatric side in preparing adolescents and young adults for care in the adult medical environment. My bias is that it is helpful to have a distinct ending of pediatric care and a discrete beginning to adult care so that there is clarity for patients whom they should be contacting and who is driving their care.

It is important for adult rheumatologists to have basic understanding of pediatric onset diseases such as the various JIA subtypes and their comorbidities, presenting symptoms and treatment of autoinflammatory d...

Some patients do benefit from overlapping care between their pediatric and adult rheumatologists, but this can be problematic when insurance coverage does not allow this to happen. One of the biggest challenges for this transfer is the establishment of a working relationship with the new provider and creating trust. In the beginning, it may be useful for an adult rheumatologist to have earlier follow-ups to help establish the relationship and develop an open dialogue about their care. Often, it is helpful for the pediatric provider to give their input about the patient by providing any personal details that an adult provider can ask about and have the patient elaborate on, such as schooling, hobbies, and other interests. As transition does ...

This is an incredibly important topic. Studies show that pediatric patients with poor transitioning have worse outcomes.

Pre-planning is best, beginning even a few years before the transfer of care so that the patient can learn essential skills such as managing one's own meds, keeping up with prescriptions, keeping an up to date medicine list at all times, making appointments and showing up on time, knowing how to get prior medical records and results, self-care, etc. This goes directly in line with Dr. @Dr. First Last's excellent comment about how the brain doesn't finish development until 25 years old.

I would recommend that all patients and their guardians be directed to the ACR's resources for transition, which include some excellent te...