The impact of a coordinated transitional care programme on adolescents with juvenile idiopathic arthritis.
OBJECTIVE
There is an extensive evidence base for the need of transitional care, but a paucity of robust outcome data. The aim of the study was to determine whether the quality of life of adolescents with juvenile idiopathic arthritis (JIA) could be improved by a co-ordinated, evidence-based programme of transitional care.


METHODS
Adolescents with JIA aged 11, 14 and 17 yrs and their parents were recruited from 10 rheumatology centres in the UK. Data were collected at baseline, 6 and 12 months including core outcome variables. The primary outcome measure was health-related quality of life (HRQL): Juvenile Arthritis Quality of Life Questionnaire (JAQQ). Secondary outcome measures included: knowledge, satisfaction, independent health behaviours and pre-vocational experience.


RESULTS
Of the 359 families invited to participate, 308 (86%) adolescents and 303 (84%) parents accepted. A fifth of them had persistent oligoarthritis. Median disease duration was 5.7 (0-16) yrs. Compared with baseline values, significant improvements in JAQQ scores were reported for adolescent and parent ratings at 6 and 12 months and for most secondary outcome measures with no significant deteriorations between 6 and 12 months. Continuous improvement was observed for both adolescent and parent knowledge with significantly greater improvement in the younger age groups at 12 months (P = 0.002).


CONCLUSIONS
This study represents the first objective evaluation of an evidence-based transitional care programme and demonstrates that such care can potentially improve adolescents' HRQL.
McDonagh
J E
JE
Division of Reproductive and Child Health, University of Birmingham, Institute of Child Health, Steelhouse Lane, Birmingham B4 6NH, UK. j.e.mcdonagh@bham.ac.uk
Southwood
T R
TR
Shaw
K L
KL
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D001171:Arthritis, Juvenile / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D003266:Continuity of Patient Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D015397:Program Evaluation; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D016896:Treatment Outcome