AB1107 Transition from paediatric to adult rheumatology services in newcastle trust hospitals
Authors: M. Obayi, M. Lee, A. Krishnakumar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Transitional care is defined as "the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult-oriented healthcare systems."<sup>1</sup> In 2016, EULAR produced recommendations on how this transition process should occur within rheumatology.<sup>2</sup> <h3>Objectives</h3> To audit the Newcastle-Upon-Tyne Hospitals rheumatology transitional care service against EULAR recommendations. <h3>Methods</h3> EULAR recommendations were adapted into a questionnaire, which was reviewed and edited by several Young Adults (YAs) with Juvenile Idiopathic Arthritis (JIA) attending clinics. Patients attending specialist YAJIA clinics between <sup>November 2017</sup> and January 2018 were asked to complete the questionnaire; responses were audited against EULAR recommendations. <h3>Results</h3> 28 YAs with JIA completed the audit questionnaire (10 males and 18 females, age range 16–25). Not all questions were answered by all YAs. Of the 17 patients with 'childhood-onset disease' (onset ≤age 10) 12% (2/17) had their transition started by age 14 ('essential' recommendation) and none by age 11 (the 'ideal' recommendation). Of the 11 patients with 'adolescent-onset disease' (onset &gt;age 10) 18% (2/11) had their transition started at the time of diagnosis (EULAR recommendation 2). 63% (17/27) of patients had ≥1 'direct' contacts with adult and paediatric rheumatology via a joint appointment (EULAR recommendation 3). 11% (3/28) of patients were aware of a documented individual transition plan (EULAR recommendation 4). 40% (6/15) were able to list ≥3 multidisciplinary team (MDT) members that had positively impacted their care. 54% (15/28) were able to provide the name of a transition coordinator (EULAR recommendation 6). 81% (21/26) of respondents 'agreed or strongly agreed' that they had been signposted to information on their condition, 48% (12/25) to peer support groups, mentoring schemes and charities, and 25% (6/24) to information sources on careers and finance. 64% (of patients were consulted on how they would like their parent/carer to be involved in their care during and after their transition (EULAR recommendation 7). 82% (23/28) of respondents reported having copies of letters concerning their care and transition (EULAR recommendation 8). <h3>Conclusions</h3> Newcastle-upon-Tyne hospitals transition services are in line EULAR recommendations in terms of MDT involvement in the transition process and addressing the medical needs of patients during transition, whilst signposting them to other agencies and ensuring they have copies of communication. The audit also identified areas for improvement including: the need for a single named coordinator for all patients; ensuring discussions with patients about the transition process begin at an earlier age, and making sure patients are aware of and able to contribute to their documented and individulised transition plan. <h3>References</h3> [1] Blum RW, Garell D, Hodgman CH, et al. Transition from child-centered to adult healthcare systems for adolescents with chronic conditions. A position paper of the Society for Adolescent Medicine. J Adolesc Health. 1993;14:570–6 [2] Foster HE, Minden K, Clemente D, et al. EULAR/PReS standards and recommendations for the transitional care of young people with juvenile-onset rheumatic diseases Annals of the Rheumatic Diseases2017;76:639–646 <h3>Disclosure of Interest</h3> None declared