OA21 Continuing specialist care beyond age 16 in young people with juvenile idiopathic arthritis: a descriptive study using electronic health records in England

Background/Aims It is estimated that juvenile idiopathic arthritis (JIA) persists into adulthood in at least one-third of patients, but it is unclear how frequently hospital services are used beyond age 16. This study aimed to describe characteristics related to continued specialist care in young people (YP) with JIA using electronic health records (EHR) in England. Methods YP with JIA were identified from primary care EHR (Clinical Practice Research Datalink GOLD and Aurum databases combined) between 2003 and 2018. JIA was identified if they had a Read code for JIA and either > =3 Hospital Episode Statistics (HES) outpatient specialist care (rheumatology/ophthalmology) appointments or a HES inpatient admission coded with JIA, prior to age 16. Further, cases needed to have linkage to HES data, registration at the same GP for >1 year beyond age 16. Cases were followed from the earliest of first Read code or first HES outpatient appointment until leaving their GP or end of 2018. YP with > =1 specialist care outpatient appointment beyond age 16 were identified. YP were considered discharged from specialist care (a proxy for disease remission) if they had > =1 year between the last appointment and end of study follow-up. Patient characteristics and characteristics of discharged are presented, stratified by continued specialist care. Results Of 1095 YP eligible for the study, followed for a median of 12 years beyond 16, 774 (70.7%) continued specialist care beyond age 16. These patients were older at first JIA code and more likely to be female (Table 1). Overall, 543 (51.9%) continued in specialist care beyond age 18. The median age of the last visit was 14 for those not continuing specialist care and 18 for those discharged after the age of 16. Disease duration was longer in those discharged after age 16. Conclusion Over two-third of patients with JIA continue to have hospital visits beyond age 16. Of those, however, approximately one-third were discharged from specialist care by the age of 18. These data provide important information for YP with JIA and their families, as well as clinicians running, developing and planning young adult services in paediatric and adult rheumatology. Disclosure R.E. Costello: None. L. Kearsley-Fleet: None. J.E. McDonagh: None. K. Hyrich: None. J.H. Humphreys: None.