SAT0518 READINESS FOR TRANSITION – CROATIAN VERSION AND PILOT EVALUATION OF THE TRANSITION READINESS ASSESSMENT QUESTIONNAIRE (TRAQ) IN RHEUMATOLOGIC PATIENTS

Abstract

Background: Rheumatic diseases of childhood extend to adulthood as an active disease in 30-70% of patients, which is the reason for requiring transition of rheumatologic care into adulthood. Transition should be individualized based on patient’s readiness, and good transition readiness analysis tools should be available at the time of transition. Objectives: As systematic review of the available assessment tools for transitional readiness in adolescents with chronic diseases has shown that only the Transition Readiness Assessment Questionnaire (TRAQ) has proven reliability in its key measurement components1, we have decided to use the TRAQ2 in pediatric rhematology patients. Methods: English version of TRAQ was translated to Croatian, afterwards a back-translation to English was done. Due to difference in the insurance policy in Croatia (health care is free for children under 18 years of age), question 9 was modified into: “Are you aware of the fact that after 18 years of age you have to start paying for the additional health insurance?“ A pilot study was performed in order to validate translated TRAQ by applying questionnaire to pediatric rheumatology patients at the time of transition. Results: A total of 41 patients at the median age of 18.25 years (range 17.8-21.1 years) were enrolled, 28 female and 13 male patients. Most of the patients had juvenile idiopathic arthritis (28 patients, 68.3%), 7 (17.1%) had mixed connective tissue disease, 3 (7.4%) had Raynaud’s syndrome and there was one patient (2.4%) with each of the following diagnosis: SLE, fibromyalgia, and polyarteritis nodosa. The mean follow up time before the transition was 5.3 years (3 months - 14 years). In general, the TRAQ was well understood and was completed in a short time by the study participants. No major difficulties were observed and all the patients were able to read and answer the questionnaire. Average score for each of the subparts of TRAQ was: managing medication 4.29 (range 2.25-5.0), appointment keeping 3.82 (1.43-5.0), tracking health issues 3.63 (1.67-5.0), talking with providers 4.68 (2.0-5.0), managing daily activities 4.39 (3.0-5.0) with overall score 4.05 (2.50-5.0), showing good overall readiness of our patients for transition. Readiness for transition in our group of patients is likely due to the age of transitioning over 18 years and good preparing for transition done by the team in the months preceding transition. Conclusion: The Croatian version of the Transition Readiness Assessment Questionnaire was validated in the population of transitional patients with chronic rheumatic diseases. It has proven to be easily applied and well understood, and its results showed adequate readiness for transition among our patients. According to our 7-year experience and 81% of follow up visits in adult rheumatology among transitioned patients in previous years, we believe that these results are correct. We shall continue following these patients through adult rheumatology visits and in few years’ time we shall verify whether they continue regular follow ups and prove to have been ready for transition as TRAQ has suggested.