Transitional care for adolescents with childhood-onset of arthritis has become of topical interest. We know that juvenile idiopathic arthritis (JIA) persists into adulthood in about 50 per cent of patients. Some of them result with impairments of body functions, individual activities and participation in society. In spite of that a lot of teenagers don’t take essential drugs regularly and 15 per cent even discontinue the whole therapy. What are the reasons and which are possibilities to prevent this breakage?
Adolescence can be a difficult time for teenagers with arthritis. They may have to struggle with delayed puberty, their continuing dependence on their parents, and the knowledge, that their condition makes them different from their friends. Rheumatology services for teenagers are under-developed so that the change from paediatric rheumatology - to adult services is a difficult phase. Many teenagers found it a shock to leave behind their paediatric health care team with whom they have had a long relationship built up over many years. By handing out documents only, the rheumatologist can neither get an overview about the course of the disease, nor he can recognize the individuals burden. Therefore Paediatric and adult rheumatologists must establish a close cooperation and must implement specific transition programmes to assemble together all the necessary components of a good transition. In order to know the special needs of the adolescents the German Rheumatology Research Centre (Deutsches Rheumaforschungszentrum) will start a prospective research project which is supported by a research grant from the German League Against Rheumatism. We are hopeful to raise awareness of the need for better transitional care for teenagers with JIA to the health care policy leading to the formation of national initiatives and to create a scientific basis for the longstanding claim of these young patients and their parents. We act from the assumption that those who are taken up to a transition programme should be able to cope better with the disease, and less complications could be expected. We hope that one day, adolescent services will become the norm in rheumatology. I think, it is feasible, it just needs organising and some imagination.