Background/Purpose: Transition is the planned, coordinated and continuous process in which an adolescent with chronic rheumatic disease is transferred from the pediatric service to an adult service. This process should address the nature of the disease and also psychosocial, vocational, educational, sexual health issues and promote healthy habits, to finally result in an autonomous young adult. This process ends when patients are mature enough in all aspects of their lives and can be responsible for their own health. The purpose of this work is to describe the first 40 patients included in the Adolescent with Rheumatic Diseases Transition Program from the Department of Rheumatology of Pontificia Universidad Católica de Chile.

Methods: We included patients between 15 and 23 years old, transferred from Pediatric Rheumatology with diagnosis of a rheumatic condition of childhood onset. These patients were included in the Program between March 2015 and January 2017. First evaluation of all adolescents was in presence of the parent or the responsible adult, in next visits at least part of the interview was just between the young adult and the doctor. In some cases before the complete transfer, one alternate adult and pediatric clinic was scheduled. In every transition clinic the HEADDSS interview for adolescents was applied, besides address the particular issues concern to the specific disease. The time between controls was determined based on diagnosis and activity of the disease. Pharmacologic adherence treatment was defined as the follow up of instructions, asking parents and patients. Clinic adherence was defined as if the patients assist or not to their appointments at Transition Clinic.

Results: Mean age of patients was 18 years old (15-23 yo), 35/40 female gender and most of them form urban areas. 21/40 teenagers has Juvenile Idiopathic Arthritis, 9/40 Pediatric Systemic Lupus Erythematosus, 3/40 Undifferentiated connective tissue disease, 2/40 Uveitis, 1/40 Fibromyalgia, 2/40 Sjögren´s Syndrome, 1/40 Morphea and 1/40 Recurrent Polychondritis. 9/40 patients had active disease at the moment of transition, 4/40 was transfer to the adult team as inpatients because of the age at the moment of admission. The mean follow up time was 9,25 months (1 – 22 months). At first interview 8/40 adolescents were seen alone by the adult rheumatologist, in last visit of each adolescent, 14/40 came alone to the meeting. 10/40 could be seen in alternate way by the pediatric rheumatologist and the adult one at the Transition Clinic. Just 3/40 teenagers didn´t continue their attention at Transition Clinic and 4/40 were non adherent to therapy at some time during follow up.

Conclusion:

This is the first report of adolescents with rheumatic conditions at Transition Clinic in our Center and shows how a planned process to move teenagers and their parents from pediatric care to the adult care has allowed the continuity of treatment and attention in most of our patients.