The transition process for paediatric rheumatology clinic patients at a single tertiary paediatric rheumatology centre in australia.

Aim: This study aimed to examine the transition process of paediatric rheumatology patients from the Monash Children's Hospital (MCH) in Melbourne in order to identify areas that could be improved. Method(s): Retrospective review of clinical data from the rheumatology database of paediatric rheumatology patients eligible for transition between January 2015 and September 2020. Result(s): 165 patients were included. 57 patients were transitioned. 14 (33%) patients transitioned to adult rheumatology had active disease and 38 (88%) were on at least one medication. All patients transitioned to the GP had inactive disease off medication. Non-systemic Juvenile Idiopathic Arthritis (JIA) was the most common diagnosis in patients transitioned. The mean age at which transition was first discussed was 18.0 years, the first referral was made at a mean of 18.3 years. The mean age at first adult appointment was 18.5 years. 39 (91%) patients had a referral completed and 8 (19%) had a transfer letter. 13 (93%) patients transferred to the GP had a transfer letter. Transfer documents to an adult public rheumatology service rated 4.3 for quality, compared to 5.5 to the GP. Transfer of care was confirmed in 40 (93%) patients transitioned to an adult service, however correspondence was available for only 3 (7%). Conclusion(s): Although the transition process at Monash Children's Hospital was adequate, it could be improved through earlier discussion of the process and improved referrals and documentation. A readiness to transfer checklist and a young adult clinic have the potential to improve the process of transition to adult rheumatology care.