ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1466

Assessment of Transition Readiness in Adolescents and Young Adults with Chronic Health Conditions

Paul Jensen1,2, Gabrielle Paul3, Stephanie LaCount4, Brendan Boyle5, Manmohan K. Kamboj6 and Stacy P. Ardoin7, 1Rheumatology, Nationwide Children's Hospital, Columbus, OH, 2Medicine, Ohio State University Medical Center, Columbus, OH, 3College of Medicine, Ohio State University, Columbus, OH, 4Pediatrics, Nationwide Children's Hospital, Columbus, OH, 5Gastroenterology, Nationwide Children's Hospital, Columbus, OH, 6Endocrinology, Nationwide Children's Hospital, Columbus, OH, 7Pediatric & Adult Rheumatology, Ohio State University, Columbus, OH

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Monday, November 9, 2015

Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects Posters. Juvenile Arthritis and Miscellaneous Rheumatic Diseases

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

The transition from pediatric to adult care is a vulnerable period associated with increased morbidity and mortality. Guidelines call for assessing patients’ transition readiness to help individualize plans. Several measurement tools have been created, but none have been prospectively evaluated. The Transition Readiness Assessment Questionnaire (TRAQ) was developed to measure transition readiness with regards to self-management (Domain 1) and self-advocacy (Domain 2). Our aim was to evaluate the TRAQ’s validity by assessing whether baseline score influenced successful transition over a 3 year period. We previously reported baseline demographic information and TRAQ scores. Here we report the transition outcomes after three years of follow up.

Methods:

89 adolescents and young adults with chronic diseases at a single pediatric center were enrolled. Participants completed a baseline survey which included demographic information, transition experience, and a TRAQ questionnaire. Study personnel conducted telephone interviews every six months for three years to determine participant health status and time at which they transitioned. Attendance at adult subspecialty provider visit was confirmed by the adult providers.  Successful transition was defined as attending at least one adult provider visit.

Results:

The 89 participants were mostly female, Caucasian, and non-Hispanic and had rheumatic (56%), gastrointestinal, (21%) or endocrine (22%) conditions. Each unit increase in TRAQ Domain 1 score increased the odds of successful transition by 1.28 (p=0.32) and each unit increase in Domain 2 score increased the odds by 1.67 (p=0.14). Of other variables measured (age, disease duration, gender, race, insurance status), only baseline age significantly predicted transition (p=0.028).

Conclusion:

This is the first study, to our knowledge, which prospectively measures the effectiveness of a transition assessment tool over a prolonged period of time. While increased baseline TRAQ scores were associated with increased odds of transition, the finding did not reach statistical significance. Additionally, disease duration, race, gender, and insurance status failed to predict transition. Although not statistically significant, the TRAQ domain 2 score predicted transition better than the domain 1 score which suggests that training in self-advocacy may help prepare the emerging adult for transition. Further research is necessary to determine optimal measurement of transition readiness in adolescents and young adults with chronic diseases.

Table 1 . Baseline TRAQ Scores

TRAQ Domain 1

Predictor

Levels

Mean (SE)

P-value*

Age group

16 to 18 years (N=52)

2.94 (0.94)

0.15

19 to 20 years (N=29)

3.35 (0.91)

>= 21 years (N=8)

3.34 (1.35)

Gender

Female (N=59)

3.12 (0.93)

0.91

Male (N=30)

3.09 (1.08)

Race

White (N=72)

3.10 (0.97)

0.78

Non-white (N=17)

3.17 (1.05)

Specialty

Rheumatology (N=50)

3.1 (1.03)

0.97

Endocrinology (N=19)

3.16 (0.98)

Gastroenterology (N=20)

3.09 (0.89)

TRAQ Domain 2

Predictor

Levels

Mean (SE)

P-value*

Age group

16 to 18 years (N=52)

3.58 (0.77)

0.02

19 to 20 years (N=29)

3.88 (0.66)

>= 21 years (N=8)

4.27 (0.54)

Gender

Female (N=59)

3.81 (0.63)

0.22

Male (N=30)

3.60 (0.92)

Race

White (N=72)

3.73 (0.80)

0.80

Non-white (N=17)

3.78 (0.42)

Specialty

Rheumatology (N=50)

3.69 (0.82)

0.31

Endocrinology (N=19)

3.64 (0.62)

Gastroenterology (N=20)

3.96 (0.62)

Table 2:  Associations Between Successful Transition and Participant Baseline Characteristics After Three Years of Follow Up

Predictor

Mean Baseline Score

Odds Ratio of Successful Transition

95% CI

P-value

Yes

No

TRAQ domain 1 score

Domain 1 score

3.22 ± 0.97

3.03 ± 0.83

1.28

0.79 – 2.10

0.32

Domain 2 score

3.90 ± 0.53

3.65 ± 0.86

1.67

0.85 – 3.27

0.14

Age (years)

18.77 ± 1.65

17.98 ± 1.49

1.39

1.04 – 1.86

0.028

Disease Duration (years)

5.21 ± 3.85

4.50 ± 4.04

1.05

0.94 – 1.17

0.42

Gender

Female (N=56)

25 (45%)

31 (55%)

0.75

0.30 – 1.88

0.54

Male (N=27)

14 (52%)

13 (48%)

1.0

Race

White (N=68)

31 (46%)

37 (54%)

0.73

0.24 – 2.25

0.59

Non-white (N=15)

8 (53%)

7 (47%)

1.0

Insurance type

Private (N=58)

29 (50%)

29 (50%)

1.5

0.53 – 4.21

0.44

Public (N=20)

8 (40%)

12 (60%)

1.0

Disclosure: P. Jensen, None; G. Paul, None; S. LaCount, None; B. Boyle, None; M. K. Kamboj, None; S. P. Ardoin, None.

To cite this abstract in AMA style:

Jensen P, Paul G, LaCount S, Boyle B, Kamboj MK, Ardoin SP. Assessment of Transition Readiness in Adolescents and Young Adults with Chronic Health Conditions [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/assessment-of-transition-readiness-in-adolescents-and-young-adults-with-chronic-health-conditions/. Accessed .

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