A Scoping Review of Transition to Adult Care in Pediatric-Onset Multiple Sclerosis: An Opportunity to Advance...

Pediatric-onset multiple sclerosis (POMS) is a chronic, immune-mediated disease of the central nervous system that accounts for up to 10% of all multiple sclerosis cases. Compared to adult-onset multiple sclerosis, POMS follows a more aggressive course with frequent relapses and earlier disability milestones. A structured transition-to-adult care is critical for maintaining long-term health. While transition-to-adult care has been studied in children with other chronic conditions, there are few transition studies in POMS, leaving youth with POMS vulnerable to poor outcomes. This scoping review aims to synthesize the existing literature on transition-to-adult care in POMS within the broader context of chronic pediatric illness and identify gaps to guide future research.

We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided scoping review in February 2025 across PubMed, Scopus, Ovid Medline, Web of Science, and Embase databases, using English-language filters. Two independent reviewers screened each record at the title/abstract and full-text stages.

Of 96 articles meeting inclusion criteria, 12 specifically addressed POMS. A range of strategies for transition-to-adult care have been studied in other chronic pediatric conditions, but findings are limited by inconsistent definitions and lack of standardized outcome measures. The POMS-specific literature reveals specific barriers, such as cognitive impairment, fluctuating symptoms, and psychosocial complexity. As a whole, there is limited evidence on the efficacy of targeted interventions to support successful transition-to-adult care.

The evidence for beneficial interventions and strategies in transition-to-adult care in POMS is limited in quantity and scope. Targeted research is needed to develop and evaluate tailored strategies informed by general care plan frameworks and disease-specific needs.