Background/Purpose:  Due to the high survival rates in chronic pediatric rheumatologic diseases a well-structured and effective transition process becomes crucial to guarantee continuity of care and maintain an adequate health status. Recommendations in regards to transition guidelines are limited and best transition practices in young patients with chronic medical needs have been poorly studied. Our aim was to evaluate transition practices from pediatric to adult rheumatology care in Brazil.

Methods:  Practicing pediatric rheumatologists registered in the Brazilian Society of Rheumatology were surveyed using a modified Childhood Arthritis and Rheumatology Research Alliance (CARRA) SurveyMonkey® questionnaire that had been used previously to evaluate transition practices of pediatric rheumatologists in the USA and Canada.

Results:  Seventy-six of 112 (68%) pediatric rheumatologists responded. Only 13% of the respondents reported that they had a well-established transition program and only 14% were satisfied with their current transition process. 80% did not use any specific tools to assess transition readiness. 43% of respondents considered 18 as the ideal transition age, but only a third of patients transitioned at that age while 48% transitioned later. Major hurdles for a successful transition included emotional attachment to the patients (95%) insufficient knowledge about a transition team (87%), lack of devoted time for transition preparation and process (80%), lack of assistance by pediatric generalists (77%), and lack of available adult subspecialists (75%). 67% of respondents stated that their program would need more tools/resources to facilitate transition and 59% believed that the development of specific guidelines would be useful to standardize and help with the transition process.

Conclusion:  Our study demonstrates that the identified challenges pertaining to transition in Brazilian patients are similar to those reported by American and Canadian pediatric rheumatologists. A comprehensive understanding of transition issues will support the development of transition guidelines and ensure better outcomes of adolescents transitioning patients.