AB1026 CLINICAL PRACTICE GUIDANCE FOR THE TRANSITIONAL CARE OF YOUNG PEOPLE WITH JUVENILE-ONSET RHEUMATIC DISORDERS IN JAPAN
Authors: Takako Miyamae, Shinji Akioka, Toru Igarashi, Yuzaburo Inoue, Motomu Hashimoto, Toshihiro Matsui, Susumu Nishiyama, Shiro Ohshima, Hiroaki Umebayashi, Takahiro Yasumi, Masaaki Mori
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The transition from pediatric to adult healthcare systems has recently received worldwide attention, and it is "the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented healthcare systems." In Japan, 1,000 patients with childhood-onset chronic disease reach adulthood every year, and many of them survive without serious sequelae or disabilities. The Japan Pediatric Society convened a committee of healthcare transition, summarized their statements, and the working group launched its activities in 2013. <h3>Objectives</h3> A clinical practice guidance for the transitional care of young people with childhood-onset rheumatic disorders has been established in Japan. <h3>Methods</h3> The guidance was designed to support pediatric and non-pediatric rheumatologic health care professionals make decisions about appropriate transitional health care for childhood-onset rheumatic disorders. It offered statements and recommendations addressing key clinical questions regarding transitional care proposed by leading pediatric and non-pediatric rheumatology medical experts and consisted of general core and disease-specific guidance. <h3>Results</h3> Category of clinical questions in the general core guidance involved the following: (1) initial statement of transitional care in rheumatology; (2) management of social life environment and public funded health care; (3) issues specific to adolescence; (4) risk management in childhood-onset rheumatic disorders; and (5) decision-making, privacy and consent, access to information, adherence to care, and preferred methods of communication, including attending to health literacy needs. In the disease-specific guidance, issues focused on each rheumatic disorder such as juvenile idiopathic arthritis, childhood-onset systemic lupus erythematosus, juvenile dermatomyositis, and Sjögren's syndrome were brought up. <h3>Conclusion</h3> The guidance informs policy and strategies to reach optimal outcomes in transitional care for both pediatric and non-pediatric rheumatologists based on available evidence and expert opinion. <h3>References</h3> [1] Miyamae T, et al. Survey of attitudes of non-pediatric rheumatologists among councilors of the Japan College of Rheumatology regarding transitional care. Mod Rheumatol. 2017;27(6):1047-1050. [2] Matsui T, et al. Survey of the awareness of adult rheumatologists regarding transitional care for patients with juvenile idiopathic arthritis in Japan. Mod Rheumatol. 2018;28(6):981-985. <h3>Disclosure of Interests</h3> Takako Miyamae Speakers bureau: AbbVie, Eisai, Bristol-Meyers, Novartis, Ayumi, Taisyo-Toyama, Chugai, Shinji Akioka Grant/research support from: Eli Lily, Speakers bureau: Pfizer, Maruho, CSL Behring, Astellas, Chugai, Toru Igarashi: None declared, Yuzaburo Inoue Grant/research support from: MSD, Speakers bureau: Novartis, CSL Behring, MSD, Taishotoyama, Ono, Motomu Hashimoto Grant/research support from: Astellas, Brystol-Meyers, Eisai, Employee of: M. H. is affiliated with the department (Department of Advanced Medicine for Rheumatic Diseases, Kyoto University), which is financially supported by four pharmaceutical companies (Tanabe-Mitsubishi, Chugai, Ayumi, UCB Japan), Speakers bureau: Tanabe Mitsubishi, Brystol-Meyers, Toshihiro Matsui Speakers bureau: Takeda, Chugai, Eisai, Pfizer, Astellas, Eli Lilly, Ono, AbbVie, Mitsubishi Tanabe, AsahiKASEI, UCB, Teijin, Susumu Nishiyama Paid instructor for: Kissei Pharmaceutical Co., Ltd, Takeda Pharmaceutical Company, Mitsubishi Tanabe Pharma, Astellas Pharma, Eisai Pharmaceutical company, AbbVie Inc., TEIJIN Pharma, Asahi Kasei Corporation, Bristol- Myers Squibb Company, Chugai Pharmaceutical Co., Ltd., Santen Pharmaceutical Co., Ltd., AYUMI Pharmaceutical Corporation, Speakers bureau: Kissei Pharmaceutical Co., Ltd, DAIICHI SANKYO COMPANY, LIMITED, Shiro Ohshima Grant/research support from: AbbVie, Eisai, Asahikasei, Speakers bureau: AbbVie, Eisai, Bristol-Meyers, Novartis, Astellas, Nippon-Kayaku, Pfizer, UCB, Ayumi, Daiichi-Sankyo, Takeda, Tanabe-Matsubishi, Chugai, Hiroaki Umebayashi Speakers bureau: AbbVie, Eisai, Novartis, Ono, Chugai, Takahiro Yasumi Shareholder of: Takeda, Speakers bureau: AbbVie, Novartis, CSL Behring, Masaaki Mori Grant/research support from: Tokyo Medical and Dental University (TMDU) received unrestricted research grants for Department of Lifetime Clinical Immunology from AbbVie GK, Ayumi Pharmaceutical Corporation, Chugai Pharmaceutical Co., Ltd., CSL Behring K.K., Japan Blood Products Organization, Mitsubishi Tanabe Pharma Corporation, Nippon Kayaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Towa Pharmaceutical Co., Ltd., UCB Japan Co. Ltd.