Assessment of Transition Readiness in Adolescents with Rheumatic Diseases: A Cross-Sectional Study

Abstract Background: Most childhood-onset rheumatic diseases are chronic health conditions, which need long-term care throughout adulthood. A well-organized transition care is challenging and patient assessment of transition skills is needed for transfer preparation to adult care setting. The Transition Readiness Assessment Questionnaire (TRAQ) is used to assess transition skills in chronically ill patients. Currently, limited transition skill assessment data exist in pediatric patients with rheumatic diseases, especially in Asian countries. This study aimed to determine the transition readiness skills in patients with rheumatic diseases and ascertain predictive factors contributing to low transition readiness skills.Methods: This is a cross-sectional study. All patients with rheumatic diseases aged 15-24 years were recruited. The TRAQ was cross-culturally adapted into the Thai language with good internal consistency and reliability. Patients completed the Thai TRAQ at the recent clinic visit and took the re-test at a 2-week interval. Demographic data, baseline characteristics, clinical manifestations, and disease status were collected. Descriptive and logistic regression analyses were performed. Results: A total of 123 patients with a mean age of 17.8 ± 2.2 years were included. Median (IQR) disease duration was 6.76 (6.05) years. The most common rheumatic disease was juvenile idiopathic arthritis (47.15%), followed by systemic lupus erythematosus (36.59%). The mean TRAQ score was 3.90 ± 0.68. Studying for a bachelor's degree (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.68–12.80) and independent clinic visits (OR 4.07, 95% CI 1.35–12.22) were predictors of a higher TRAQ score. Lack of knowledge on health insurance coverage and financial management were two issues causing lower TRAQ scores. Furthermore, patients with inactive disease status (OR 5.60, 95% CI 1.20–26.14) and patients, who had dependent clinic visits (OR 4.13, 95% CI 1.60–10.67), had more opportunities of getting lower TRAQ scores.Conclusions: Patients with a higher level of education had a higher chance of successfully transitioning to adult care, whereas patients, who had inactive disease and dependent clinic visits, had less transition readiness skills. Physicians and parents should educate their children on independent living skills and paying particular attention to two issues: health insurance coverage and financial management.