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The coming of age of adolescent rheumatology

Abstract

The goal of planned adolescent health-care transition procedures is to optimize functioning and well-being for all young people, including those who have special health-care needs. In this regard, the transitioning of young people with childhood-onset rheumatic diseases to adult health care is increasingly important, particularly as many of these patients might continue to have active disease or considerable sequelae well into their adult lives. Key components of a successful plan for health-care transition include encouragement of patient self-advocacy, tailoring of the process to each individuals' needs, family adaptation, and readiness and training of relevant health-care providers. Improving outcomes in patients with serious rheumatic diseases presenting in adolescence will be achieved by increasing our understanding of the aetiopathogenesis of these disorders, identifying accurate predictors of the development and/or course of disease and better defining long-term outcomes. In this article, we discuss transitional health-care models, as well as the benefits and challenges of providing transitional care to adolescents with rheumatic diseases. We also highlight the need to ensure that research is integral to transitional care pathways.

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Figure 1: Schematic demonstration of the key concepts that should be considered to ensure a smooth transition of clinical care and the continuation of high-quality research during the transfer of patients between paediatric and adult health-care and research environments.

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Acknowledgements

D. Eleftheriou and Y. Ioannou acknowledge research support from Arthritis Research UK (grant 20164). Y. Ioannou also acknowledges support from the National Institute for Health Research University College London Hospitals Biomedical Research Centre.

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D. Eleftheriou and Y. Ioannou contributed equally to researching data for the article and writing the manuscript. D. Eleftheriou, L. R. Wedderburn and Y. Ioannou made substantial contributions to discussion of content. All authors reviewed and/or edited the manuscript before submission.

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Correspondence to Yiannis Ioannou.

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Eleftheriou, D., Isenberg, D., Wedderburn, L. et al. The coming of age of adolescent rheumatology. Nat Rev Rheumatol 10, 187–193 (2014). https://doi.org/10.1038/nrrheum.2013.202

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