Adolescents with arthritis need more information when transitioning to adult care

Helping adolescents with arthritis develop the skills and secure resources to assure that their health care needs are met as they transition to adulthood is an important issue in the U.S. In general, the frequency of which young people with special health care needs receive transition services is low and, to date, no studies have examined this frequency.

A new study examined the extent to which adolescents with arthritis receive transition services and compared these rates to youth with other special care health needs. The study was published in the January issue of Arthritis Care & Research.

Led by Peter Scal of the University of Minnesota, researchers used information from the 2005-2006 National Survey of Children with Special Health Care Needs to identify adolescents aged 12 to 17 who had arthritis and to assess responses to questions about the transition to adulthood and adult-oriented health care.

The results showed that nearly three-quarters of adolescents with arthritis were encouraged to take responsibility for their health care needs and about half discussed how their needs might change when they became an adult. Only one in five, however, received counseling about the need to transfer to adult-oriented physicians and how to obtain health insurance as an adult. These results were similar to young people with special health care needs nationally, but lag behind those with diabetes.

"Health care transition is a complex set of tasks that are embedded within a complex developmental period and a complex heath care system," the authors note. "It is not surprising, then, than the development and evaluation of services to facilitate health care transition has been slow." However, a systematic approach to this problem can show results.

In the UK, for example, the British Society of Paediatric and Adolescent Rheumatology has developed a comprehensive health care transition program for youth with arthritis that appears to have a positive impact.

In the U.S., there seems to be much room for improvement is assisting adolescents with arthritis in achieving a successful health care transition into adulthood. "More research is needed to understand youth's perspectives regarding their health care transition needs that should include items related specifically to health care transition, as well as how health care transition needs intersect with social, educational, and vocational concerns," the authors conclude.