Transitioning Young Adult Patients from Pediatric to Adult Rheumatology Practices in Rhode Island

Young adults with rheumatic conditions encounter challenges when transitioning to an adult rheumatologist. At the Hasbro Pediatric Rheumatology Clinic, patients aged 18 and older were historically provided a list of adult rheumatologists; however, no formal transition process existed. We assessed the feasibility and acceptability of a pilot model to systematically transition pediatric patients to an adult rheumatologist using aspects of the Six Core Elements of Health Care Transition (HCT) from Got Transition®.

A multidisciplinary team facilitated the program. Eligibility included: 18 years of age with stable, confirmed (or suspected) rheumatic disease. Program structure was implemented across three pediatric and one adult visit. Patient-reported transition readiness was assessed at initial and final pediatric visits using the Transition Readiness Assessment (TRA) from Got Transition®.

Sixty-four patients aged 18 and older had appointments with the Hasbro Pediatric Rheumatology Clinic from May 1, 2024 to Jan. 31, 2025. Thirteen were eligible; eight entered the pilot (61.5%). The mean age at recruitment was 19.5 years (range: 18-23). The study achieved a 62.5% retention rate, with 80% completion of video visits with adult rheumatologists and zero no-shows. TRA scores were high at baseline, although of note patients initially scored their readiness lower in areas related to transition confidence and navigating health care. The greatest mean score increase was seen for navigating health care (+2.7).

This rheumatology transition pilot demonstrated preliminary feasibility. Systemic changes to reimbursement and clinician education are needed to support HCT sustainability.