title: Systematic review and critical appraisal of transitional care programmes in rheumatology.
abstract: Identify existing models of transitional care in rheumatic and musculoskeletal diseases (RMD), describe their strengths and weaknesses, and provide support to a consensus initiative to develop recommendations for transitional care.
  
  
  
  A systematic review was conducted to identify publications describing transition programmes in RMD. Eligibility for inclusion required detailed description of the programme. Descriptive information was collected, including country of the programme, target diseases and ages of the patients, resources, elements of the transition process and, when described, outcomes and quality indicators. Quality assessment of the programmes included: level of definition and the evidence base for the programme, availability of quality indicators and evidence of effectiveness.
  
  
  
  Overall, 27 articles were identified and evaluated, related to 8 programmes in 6 countries: 4 covered all RMDs, 3 specific for patients with juvenile idiopathic arthritis (JIA) and 1 programme generic for chronic diseases and adapted for RMD. Core elements of these transition programmes included the following: a written transition policy; patient individualised planning and flexibility of transitional care; designation of transition coordinator role; acquisition of knowledge and skills in self-management of care; decision making, shared care and communication between paediatric and adult health care provider teams and a planned transfer to adult rheumatology. Only 2 provided evidence of effectiveness according to previously specified outcome measures.
  
  
  
  Transitional care programmes in RMDs are variable in their structures, staffing and processes. There are no standardised measures of outcome or effectiveness. This information provides important valuable insights and strategies to develop transitional care in RMD.
authors: Paediatric Rheumatology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
authors: Daniel
authors: D
authors: Clemente
authors: Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IDISSC), Hospital Clinico San Carlos, and Health Sciences, Universidad Camilo José Cela, Madrid, Spain. Electronic address: lleon.hcsc@salud.madrid.org.
authors: Leticia
authors: L
authors: Leon
authors: Musculoskeletal Research Group, Institute Cellular Medicine, Great North Childrens Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle University, Newcastle upon Tyne, UK.
authors: Helen
authors: H
authors: Foster
authors: Department of Rheumatology and Clinical Immunology, German Rheumatism Research Centre, a Leibniz Institute, Charité University Medicine Berlin, Berlin, Germany.
authors: Kirsten
authors: K
authors: Minden
authors: Instituto de Salud Musculoesquelética, Madrid, Spain.
authors: Loreto
authors: L
authors: Carmona
mesh_terms: D001171:Arthritis, Juvenile / Q000628:therapy*; D002908:Chronic Disease; D006801:Humans; D017063:Outcome Assessment, Health Care; D012219:Rheumatology; D012648:Self Care; D060305:Transition to Adult Care; D000069341:Transitional Care
keywords: Adolescence, Rheumatic diseases; Critical appraisal; Systematic review; Transitional care