Changes in Transition Readiness in Youth With Juvenile Idiopathic Arthritis and Systemic Lupus Erythematosus: A Longitudinal Study.

OBJECTIVE

For youth with juvenile idiopathic arthritis (JIA) and childhood-onset systemic lupus erythematosus (cSLE), the time leading up to the transfer from pediatric to adult care is an especially vulnerable, yet optimal time to support building healthcare self-management skills. Few studies have explored how readiness for transition changes over time prior to transfer. We aimed to assess transition readiness over time in youth with JIA or cSLE.

METHODS

Patients aged 14-17 years with JIA or cSLE were recruited from the McMaster Rheumatology Transition Clinic and asked to complete the 14-item Transition-Q (maximum score 100) at each clinic visit to assess transition readiness. Descriptive statistics summarized patient demographics. Generalized estimating equations assessed transition readiness across multiple clinic visits and evaluated the role of sex, age at enrollment, and age at diagnosis.

RESULTS

Analyses included 392 clinic visits from 94 participants. The number of clinic visits per participant ranged from 2 to 8, with varying time between visits. More visits (all P < 0.001), female sex (β 4.5, P = 0.03), and older age at baseline (β 3.6, P < 0.001) were significant positive predictors of higher or improved Transition-Q scores, whereas age at diagnosis was not significant (P = 0.48). There was no significant interaction between sex and number of visits.

CONCLUSION

Our study demonstrated transition readiness increases at each clinic visit, with female sex and older age at enrollment positively predicting higher Transition-Q scores over time; however, longitudinal trajectories did not differ by sex. This suggests that male individuals and younger adolescents may require additional supports to optimize transition readiness.