Autoimmune rheumatic transitional care model development

Area of Science:

• Rheumatology
• Pediatric Rheumatology
• Healthcare Transition

Background:

• Autoimmune rheumatic diseases require specialized care during the transition from pediatric to adult healthcare.
• Existing transitional care models may not adequately address the unique needs of these patients.
• Effective transition management is crucial for long-term health outcomes.

Purpose of the Study:

• To develop a comprehensive transitional care model for patients with autoimmune rheumatic diseases.
• To base the model on a thorough analysis of patient needs during the transition period.
• To improve the continuity and quality of care for young adults with rheumatic conditions.

Main Methods:

• A mixed-method explanatory sequential design (QUAN-qual) was employed.
• Quantitative data were gathered via medical records and structured interviews.
• Qualitative data were collected through Focused Group Discussions (FGD) to explore issues identified in the quantitative phase.

Main Results:

• Data from 27 patients revealed transition ages of 18-19 years, with Systemic Lupus Erythematosus (SLE) and Juvenile Idiopathic Arthritis (JIA) being common diagnoses.
• Significant challenges included diagnostic discrepancies (7.4%), medication changes (51.9%), and lack of initial disease activity data (96.3%).
• FGD analysis highlighted a strong "need for change" in existing transitional care processes.

Conclusions:

• A transitional care model for autoimmune rheumatic diseases has been developed.
• The model includes essential components such as service algorithms, transfer documents, and systematic work protocols with education checklists.
• This structured approach aims to standardize and enhance the care transition process.