Versailles Hospital, Department of Pediatrics, Le Chesnay.
Department of Pediatric Rheumatology, Necker Hospital, Paris.
J Clin Rheumatol. 2024 Oct 1;30(7):297-299. doi: 10.1097/RHU.0000000000002132. Epub 2024 Aug 26.
Transitioning from pediatric to adult care is a critical step for individuals with autoinflammatory diseases, requiring effective programs to ensure continuity of care and disease management. Despite various recommendations, the effectiveness of transition programs, particularly in monogenic autoinflammatory diseases, remains understudied.
A single-center medical records review study was conducted at the French National Reference Center for Adult Autoinflammatory Diseases in Tenon Hospital from 2017 to 2023. All patients who had consulted for the first time between the ages of 15 and 30 years and had received care for an autoinflammatory disease during childhood were included. The patients were classified according to whether they had undergone a transition, defined as either no transition, simple transition (referral letter), or joint transition (pediatrician and adult physician consultation).
One hundred eleven patients (median age, 18 years) were included. Patients who consulted without transition started adult follow-up and were followed up less regularly than those who underwent the transition process ( p < 0.001 and p = 0.028). In patients with familial Mediterranean fever, the absence of a formal transition was associated with poorer disease control at baseline ( p = 0.019). The type of transition did not impact disease control during follow-up.
Participation in a transition program is associated with earlier and more regular follow-up in adulthood. Although transition type did not significantly impact disease control during follow-up in familial Mediterranean fever, the potential benefit of joint consultation extends beyond consultation frequency and disease outcomes, encompassing patient perspectives and self-management abilities. This study highlights the significance of collaborative transition programs in AIDs.
从儿科到成人护理的过渡是自身炎症性疾病患者的关键步骤，需要有效的计划来确保护理的连续性和疾病管理。尽管有各种建议，但过渡计划的有效性，特别是在单基因自身炎症性疾病中，仍研究不足。
在 2017 年至 2023 年期间，在 Tenon 医院的法国国家成人自身炎症性疾病参考中心进行了一项单中心病历回顾研究。纳入所有在 15 至 30 岁之间首次就诊且在儿童期接受过自身炎症性疾病治疗的患者。根据患者是否进行了过渡（无过渡、简单过渡（转诊信）或联合过渡（儿科医生和成人医生咨询）进行分类。
共纳入 111 例患者（中位年龄 18 岁）。未进行过渡而就诊的患者开始接受成人随访，随访不如过渡患者规律（p<0.001 和 p=0.028）。在家族性地中海热患者中，无正式过渡与基线时疾病控制较差相关（p=0.019）。过渡类型在随访期间对疾病控制没有影响。
参与过渡计划与成年后更早和更规律的随访相关。尽管在随访期间，过渡类型对家族性地中海热的疾病控制没有显著影响，但联合咨询的潜在益处不仅限于咨询频率和疾病结局，还包括患者的观点和自我管理能力。本研究强调了协作过渡计划在自身免疫性疾病中的重要性。
