Changes in Transition Readiness in Youth with Arthritis and Lupus: A Longitudinal Study.

Abstract

For youth with Juvenile Idiopathic Arthritis (JIA) and childhood-onset Systemic Lupus Erythematosus (cSLE), the time leading up to the transfer from pediatric to adult care is especially vulnerable, yet an optimal time to support building healthcare self-management skills. Few studies have explored how readiness for transition changes over time prior to transfer. To assess transition readiness over time in youth with JIA or cSLE. Patients 14-17 years with JIA or cSLE were recruited from the McMaster Rheumatology Transition Clinic and asked to complete the 14-item Transition-Q (max 100) at each clinic visit to assess transition readiness. Descriptive statistics summarized patient demographics. Generalized estimating equations assessed transition readiness across multiple clinic visits and evaluated the role of sex, age at enrollment, or age at diagnosis predicted baseline readiness or its change over time. Analyses included 384 clinic visits from 94 participants. Number of clinic visits per participant ranged from 2 to 8, with varying time between visits. More visits (all p=<0.001), female sex (β=4.45, p=0.03), and older age at baseline (β=3.68, p<0.001) were significant positive predictors of higher scores/improvement in Transition-Q scores, while age at diagnosis was not significant (p=0.47). There was no significant interaction between sex and number of visits. Our study demonstrated transition readiness increases at each clinic visit, with females and older age at enrollment positively predicting higher Transition-Q scores over time; however longitudinal trajectories did not differ by sex. This suggests that males and younger youth may require additional supports to optimize transition readiness.