Transitions in medical care can be high-risk periods due to the loss of continuity in care and worsening of medical conditions. Approximately one-quarter of the estimated 18 million adolescents aged 18–21 years in the U.S. have chronic conditions, including rheumatic diseases.2 As most youth with rheumatic and other chronic illnesses survive into adulthood, they, along with their healthier counterparts, need to transition from pediatric to adult healthcare providers. National surveys show that most parents, youth and young adults are unprepared for this change, and providers are looking for a systematic way to support their patients through this transition.3 Data show that without transition support, young adults have diminished health, compromised quality of care and increased healthcare costs.4
Unsatisfactory transitions can be attributed to many factors, including individual patient factors (e.g., limited self-management and self-advocacy skills, lack of family support) and system factors (e.g., changes in insurance coverage, communication gaps between health providers and health systems, lack of provider education about transition and access to care). Anecdotally, even when young adults “transfer” to the same provider within the same health system, gaps in care may occur.
Interventions in rheumatology practice can improve transition processes.
Surveys of young people with rheumatic disease indicate that they want independence in their care and information about the adult healthcare system. They are interested in knowing about the adult provider’s training and how to access adult health care.25,26