AB1026 CLINICAL PRACTICE GUIDANCE FOR THE TRANSITIONAL CARE OF YOUNG PEOPLE WITH JUVENILE-ONSET RHEUMATIC DISORDERS IN JAPAN

Abstract

Background The transition from pediatric to adult healthcare systems has recently received worldwide attention, and it is “the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented healthcare systems.” In Japan, 1,000 patients with childhood-onset chronic disease reach adulthood every year, and many of them survive without serious sequelae or disabilities. The Japan Pediatric Society convened a committee of healthcare transition, summarized their statements, and the working group launched its activities in 2013. Objectives A clinical practice guidance for the transitional care of young people with childhood-onset rheumatic disorders has been established in Japan. Methods The guidance was designed to support pediatric and non-pediatric rheumatologic health care professionals make decisions about appropriate transitional health care for childhood-onset rheumatic disorders. It offered statements and recommendations addressing key clinical questions regarding transitional care proposed by leading pediatric and non-pediatric rheumatology medical experts and consisted of general core and disease-specific guidance. Results Category of clinical questions in the general core guidance involved the following: (1) initial statement of transitional care in rheumatology; (2) management of social life environment and public funded health care; (3) issues specific to adolescence; (4) risk management in childhood-onset rheumatic disorders; and (5) decision-making, privacy and consent, access to information, adherence to care, and preferred methods of communication, including attending to health literacy needs. In the disease-specific guidance, issues focused on each rheumatic disorder such as juvenile idiopathic arthritis, childhood-onset systemic lupus erythematosus, juvenile dermatomyositis, and Sjogren’s syndrome were brought up. Conclusion The guidance informs policy and strategies to reach optimal outcomes in transitional care for both pediatric and non-pediatric rheumatologists based on available evidence and expert opinion.