Survey of the awareness of adult rheumatologists regarding transitional care for patients with juvenile idiopathic arthritis in Japan

Abstract

Objectives: To understand the current status of adult rheumatology care for patients who had previously had juvenile idiopathic arthritis (JIA) (excluding systemic JIA), and to identify issues interfering with the transition from pediatric to adult care in Japan.

Methods: Questionnaire-based survey among 30 adult rheumatologists.

Results: Eighty-seven percent of adult rheumatologists responded that they had provided medical care to adults who had had JIA; 44% of them had felt hesitation or anxiety when providing such care. The reasons for this included lack of independence of the patients, lack of knowledge and experience among adult rheumatologists, and lack of preparation for accepting such patients. Many adult rheumatologists believed that the timing of transition from pediatric to adult rheumatology care must be considered based on therapeutic regimens or clinical conditions/disease states, not solely chronological age. A majority of adult rheumatologists showed great interest in transitional care for JIA patients and desired to communicate better with pediatric rheumatologists.

Conclusion: Transitional care for JIA patients is not sufficiently developed in Japan. Education and advocate campaign of transitional care is required for adult rheumatologists as well as patients and their parents.

Keywords:

• Juvenile idiopathic arthritis
• transitional care
• rheumatologist
• questionnaire

Acknowledgements

We sincerely thank the physicians who work in the hospitals affiliated with NinJa for their cooperation with our survey. We also thank Ms. Tomoko Takahashi for secretarial assistance.

Conflict of interest

Tokyo Medical and Dental University (TMDU) received unrestricted research grants for Department of Lifetime Clinical Immunology from AbbVie GK, Ayumi Pharmaceutical Corporation, Chugai Pharmaceutical Co., Ltd., CSL Behring K.K., Japan Blood Products Organization, Mitsubishi Tanabe Pharma Corporation, Nippon Kayaku Co., Ltd., Ono Pharmaceutical Co., Ltd., Towa Pharmaceutical Co., Ltd., UCB Japan Co. Ltd., with which TMDU paid the salary of Toshihiro Matsui, Fumio Hirano, and Masaaki Mori. The other authors declare no conflicts of interest associated with this manuscript.

Additional information

Funding

This research is supported by the Practical Research Project for Allergic Diseases and Immunology (Research on Allergic Diseases and Immunology) from the Japanese Agency for Medical Research and Development, AMED.