Transition of Patients with Systemic Lupus Erythematosus from Pediatric to Adult-oriented Rheumatology Care

Overview

Journal Turk J Med Sci

Specialty General Medicine

Date 2024 Dec 30

PMID 39734331

Authors

Seher Sener

Gozde Kubra Yardimci

Ezgi Deniz Batu

Levent Kilic

Ummusen Kaya Akca

Muserref Kasap Cuceoglu

Zeynep Balik

Ozge Basaran

Yelda Bilginer

Sule Apras Bilgen

Seza Ozen

Affiliations

Soon will be listed here.

Abstract

Background/aim: The transition from pediatric to adult-oriented care for individuals with juvenile-onset systemic lupus erythematosus (SLE) poses significant challenges. This study aimed to assess the outcomes of transitioning patients with juvenile-onset SLE from pediatric to adult-oriented care.

Materials And Methods: Patients with juvenile-onset SLE were included in the study. They were transferred in face-to-face meetings where at least one pediatric rheumatologist and one adult rheumatologist were present (transition time: October-December 2020).

Results: The median (25th-75th percentile) age at diagnosis and the time of the first examination in an adult-oriented rheumatology department of the included 65 SLE patients were 14.3 (10.9-15.1) years and 19.2 (18.5-20.4) years, respectively (female/male ratio: 7.1). There was no difference in clinical findings related to SLE between the last pediatric care visit and the last adult-oriented care visit other than constitutional symptoms being more prevalent in adult-oriented care (p = 0.039). There was a higher rate of low medication adherence in the post- than pretransition period (p = 0.003). The number of patients admitted to the emergency department during follow-up in adult-oriented care was higher (p = 0.009). Additionally, patients were more likely to miss at least one scheduled appointment in the post- than pretransition period (p = 0.002).

Conclusion: We observed that patients with juvenile-onset SLE had more constitutional symptoms, lower medication compliance, higher rates of emergency department visits, and more missed appointments in the posttransition period despite a face-to-face structured transition process. We hope that future studies will offer solutions to the problems in transitional care.

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