Transitional concepts for juvenile idiopathic arthritis. Planning the transition from pediatric care to management by internists specialized in rheumatology

Juvenile idiopathic arthritis belongs to the most common chronic diseases beginning in childhood and adolescence. Often the disease remains active in adulthood and is associated with increased risks of morbidity, disability, and disturbances of participation. Therefore, a steady continuation of medical rheumatologic care and psychosocial support is also needed in adolescence and adulthood. The term "transition" means a multidisciplinary care concept with the goal of coordinated and continuous care for adolescents with chronic rheumatic diseases in the transition from pediatric rheumatology to adult-oriented care. Today many adolescents with a rheumatic disease have inadequate knowledge and self-management and are not or insufficiently prepared for the change to the care of internists specialized in rheumatology. At numerous centers for pediatric rheumatology a transitional program was established to improve the transitional care in adolescence and prepare the patients for the transfer problem. Nevertheless the medical care situation for young people suffering from rheumatic diseases has structural deficits in the transitional phase and insufficient support of the health policy.