ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1429

A Quality Update: Improved Transfer Time Among Rheumatology Patients Transferring from Pediatric to Adult Care at an Academic Medical Center

Kimberly DeQuattro1, Michael Evans1, Aimee O. Hersh2, Jinoos Yazdany1, Emily von Scheven3 and Erica Lawson3, 1Medicine/Rheumatology, University of California, San Francisco, San Francisco, CA, 2Pediatrics/Rheumatology, University of Utah, Salt Lake City, UT, 3Pediatrics/Rheumatology, University of California, San Francisco, San Francisco, CA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: adolescent patients and quality improvement, Transition

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Monday, October 22, 2018

Title: Pediatric Rheumatology – Clinical Poster II: Autoinflammatory Disorders, Scleroderma, and Miscellaneous

Session Type: ACR Poster Session B

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

Background/Purpose: Transfer from pediatric- to adult-oriented health care is challenging for patients with childhood-onset rheumatologic disease, and may be associated with treatment non-adherence, disease flares and urgent healthcare utilization. This study aimed to measure transition outcomes among young adults transferring from pediatric to adult care at a single US academic medical center, before and after implementation of transition process improvements.

Methods: Transition process improvements implemented by the pediatric rheumatology practice between 2012 and 2017 included the creation of a transition policy, systematic identification of transition-age patients, and quarterly transition planning rounds. Electronic health record (EHR) query was used to identify patients who transferred from pediatric to adult rheumatology care within the institution during 2012-2017. Primary endpoints were transfer time (time from last pediatric to first adult appointment) and successful transfer. Successful transfer was defined as 1) transfer time from pediatric to adult care <6 months and 2) completion of >2 visits with an adult provider within a 12-month period. Secondary endpoints were pre- and post- transfer disease activity as measured by physician global assessment or SLEDAI score (active v. inactive), and insurance type (public, private, both). We compared outcomes to those of patients who transferred during 1995-2005, prior to the implementation of transition support processes. Bivariate statistics were used to compare differences between groups.   

Results: 87 patients transferred from pediatric to adult rheumatology care during 2012-2017, and 31 patients transferred during 1995-2005 (Table 1). Diagnoses were similar in both groups. During 2012-2017, median transfer time was significantly shorter (3.5 v. 7.1 months, p=0.03), and 52% of patients transitioned successfully. Transitioning patients were more likely to have active disease in 1995-2005, both pre-transfer (61% vs 29%, p=0.001) and post-transfer (61% vs 26%, p=0.001). More patients were publicly insured pre-transfer during 1995-2005 (74% public and 26% private vs. 42% public, 55% private and 2% both, p=0.009), but there were no differences in insurance type post-transfer.

Conclusion: During the implementation of transition initiatives, median transfer time from pediatric to adult rheumatology significantly decreased, and over half of patients transferred successfully. Disease activity at the time of transfer also improved, which may reflect improvements in disease management or differences in disease severity. Although direct causal associations between transition support interventions and transfer success cannot be made, this study suggests that implementation of structured transition processes may positively impact the transfer to adult care.

Table 1.  Characteristics and Transition Outcomes of Young Adults Transferring from Pediatric to Adult Rheumatology Care at an Academic Medical Center, 1995-2005 and 2012-2017

Variable

Transferred 1995-2005

(N = 31)

Transferred 2012-2017

(N = 87)

P

 

N (%) unless noted

 

Demographics

 

 

 

     Female

23 (74)

73 (84)

NS

     Age pre-transfer, mean (SD)*

19.6 (1.2)

20.4 (1.2)

0.001

     Race

 

 

NS

          White

10 (32)

29 (33)

 

          African American

2 (6)

8 (9)

 

          Asian

7 (23)

25 (29)

 

          Other

12 (38)

25 (29)

 

Disease characteristics

 

 

 

     Rheumatologic diagnosis

 

 

0.07

          JIA

5 (16)

30 (34)

 

          SLE

16 (52)

27 (31)

 

          Other

10 (32)

30 (34)

 

     Active disease pre-transfer*

19 (61)

25 (29)

0.001

     Active disease post-transfer*

19 (61)

23 (26)

0.001

Health Insurance

 

 

 

     Pre-transfer

 

 

0.009

          Public

23 (74)

37 (42)

 

          Private

8 (26)

48 (55)

 

          Both

0 (0)

2 (2)

 

     Post-transfer

 

 

NS

          Public

14 (45)

32 (36)

 

          Private

17 (55)

53 (60)

 

          Both

0 (0)

2 (2)

 

Transition Outcomes

 

 

 

     Transfer time (months), median (range)+

7.1 (0.7-33.6)

3.5 (0.3-45.7)

0.03

     Successful transfer^

53.8%

N/A

 

JIA = Juvenile Idiopathic Arthritis, SLE = Systemic Lupus Erythematosus

* Active disease = presence of active disease according to physician global assessment or SLEDAI, Pre-transfer = final pediatric rheumatology visit, post-transfer = first adult rheumatology visit

+ Transfer time = Time from last pediatric appointment to first adult appointment.

^ Successful transfer = 1) transfer time <6 months, and 2) completion of >2 visits with an adult provider within a 12-month period.

 


Disclosure: K. DeQuattro, None; M. Evans, None; A. O. Hersh, None; J. Yazdany, None; E. von Scheven, None; E. Lawson, None.

To cite this abstract in AMA style:

DeQuattro K, Evans M, Hersh AO, Yazdany J, von Scheven E, Lawson E. A Quality Update: Improved Transfer Time Among Rheumatology Patients Transferring from Pediatric to Adult Care at an Academic Medical Center [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/a-quality-update-improved-transfer-time-among-rheumatology-patients-transferring-from-pediatric-to-adult-care-at-an-academic-medical-center/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-quality-update-improved-transfer-time-among-rheumatology-patients-transferring-from-pediatric-to-adult-care-at-an-academic-medical-center/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology