Consensus of the Spanish society of pediatric rheumatology for transition management from pediatric to adult care in rheumatic patients with childhood onset.
To develop recommendations on the transition from pediatric care to adult care in patients with chronic inflammatory rheumatic diseases with childhood onset based. Recommendations were generated following nominal group methodology and Delphi technique. A panel of 16 experts was established. A systematic literature review (on transitional care) and a narrative review were performed and presented to the panel in the first panel meeting to be discussed. A first draft of recommendations was generated and circulated. Focal groups with adolescents, young adults and parents were organized. In a second meeting, the focus group results along with the input from invited psychologist were used to establish definitive recommendations. Then, a Delphi process (two rounds) was carried out. A group of 72 pediatric and adult rheumatologists took part. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70 % voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford center for evidence-based medicine levels of evidence. Transition care was defined as a purposeful, planned process that addresses the medical, psychosocial and educational/vocational needs of adolescents and young adults with chronic inflammatory rheumatic diseases with childhood onset as they move from child-centered to adult-oriented healthcare systems. The consensus covers: transition needs, barriers and facilitators, transitional issues (objectives, participants, content, phases, timing, plans, documentation and responsibilities), physicians' and other health professionals' knowledge and skill requirements, models/programs, and strategies and guideline for implementation. Preliminary recommendations and agreement grade are shown in the Table (first Delphi round). These recommendations are intended to provide health professionals, patients, families and other stakeholders with a consensus on the transition process from pediatric to adult care.
Servicio de Pediatría, H La Fe, Valencia, Spain. calvo_inm@gva.es.|Hospital Universitari i Politècnic La Fe, Avinguda de Fernando Abril Martorell, nº 106, 46026, Valencia, Spain. calvo_inm@gva.es.
Inmaculada
I
Calvo
Servicio de Pediatría, H Sant Joan de Deu, Esplugues de Llobregat, Spain.
Jordi
J
Antón
Servicio de Reumatología, HU de Canarias, Santa Cruz de Tenerife, Spain.
Sagrario
S
Bustabad
Servicio de Pediatría, HU Virgen del Rocío, Seville, Spain.
Marisol
M
Camacho
Unidad de Reumatología Pediátrica, H 12 de Octubre, Madrid, Spain.
Jaime
J
de Inocencio
Servicio de Reumatología, H Ramón y Cajal, Madrid, Spain.
M Luz
ML
Gamir
Servicio de Reumatología, EOXI CHU A Coruña, A Coruña, Spain.
Jenaro
J
Graña
Servicio de Pediatría, H Universitari Son Dureta, Mallorca, Spain.
Lucía
L
La Cruz
Servicio de Pediatría, H del Niño Jesús, Madrid, Spain.
Juan Carlos López
JC
Robledillo
Servicio de Reumatología, H Miguel Servet, Saragossa, Spain.
Marta
M
Medrano
Unidad de Reumatología Pediátrica, H La Paz, Madrid, Spain.
Rosa
R
Merino
Servicio de Reumatología, H Vall d'Hebron, Barcelona, Spain.
Consuelo
C
Modesto
UGC de Pediatría, H Materno Infantil, H Regional Universitario de Málaga, Málaga, Spain.
Esmeralda
E
Nuñez
Servicio de Pediatría, HU Cruces, Barakaldo, Bizkaia, Spain.
M Jesús
MJ
Rua
Servicio de Reumatología, H General Hospitalet-Moisès Broggi, Sant Joan Despí, Spain.
Vicenç
V
Torrente-Segarra
Servicio de Reumatología, HU Virgen Macarena, Seville, Spain.
Carmen
C
Vargas
Instituto de Salud Musculoesquelética, Madrid, Spain.
Loreto
L
Carmona
Instituto de Salud Musculoesquelética, Madrid, Spain.
Estíbaliz
E
Loza
D000293:Adolescent; D000328:Adult; D006801:Humans; D010372:Pediatrics; D012216:Rheumatic Diseases / Q000628:therapy*; D012219:Rheumatology; D013030:Spain; D060305:Transition to Adult Care; D055815:Young Adult
Adolescent; Pediatric rheumatology; Transitional care