Courel-Ibáñez Javier, Prieto-Moreno Rafael, Briones-Vozmediano Erica, Ariza-Vega Patrocinio, Angevare Saskya, Anton Jordi, Bini Ilaria, Clemente Daniel, Correia Matilde, Costello Wendy, De Cock Diederik, Domjan Andrea, Leon Leticia, Marques Andrea, Minden Kirsten, Mourão Ana Filipa, Najm Aurelie, Özen Seza, Pimentel Georgina, Saleem Zainab, Vetrovsky Tomas, Wulffraat Nico, Zacarias Andrea, Prior Yeliz, Carmona Loreto, Estévez-López Fernando
Department of Physical Education and Sport, University of Granada, Granada, Spain. Electronic address: https://x.com/javiercourel.
Department of Education, Faculty of Education Sciences, CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Centre, University of Almería, Almería, Spain; Biomedical Research Unit, Torrecárdenas University Hospital, Almería, Spain.
Ann Rheum Dis. 2025 Feb 11. doi: 10.1016/j.ard.2025.01.017.
To synthesise existing evidence on transitional care programmes for young people with juvenile-onset rheumatic and musculoskeletal diseases (jRMDs), focusing on their structure and implementation, the qualitative experiences and perceptions of those involved, and the quantitative outcomes associated with these programmes. Together with additional information, these insights have informed the European Alliance of Associations for Rheumatology (EULAR) Points to Consider for patient education in physical activity and self-management of pain in jRMDs during transitional care.
A systematic literature review was conducted with a broadened scope beyond patient education in physical activity and self-management of pain to provide a comprehensive overview of transitional care in rheumatology, aiming to optimise current strategies, support evidence-based approaches, and identify areas for clinical improvement. The search was conducted in PubMed and the Cochrane Library from inception until November 1, 2023. Descriptive, qualitative, and quantitative studies were included. Two researchers independently conducted the search, screening, data extraction, and quality assessment.
From 31 studies, we identified 18 transitional care programmes with key approaches, including individualised and developmentally appropriate plans that often integrate educational strategies. These programmes, which generally aim to increase readiness to transfer, health-related quality of life, and continuity of care, frequently involved multidisciplinary teams and early intervention strategies. Young people with jRMDs and their families reported satisfaction with these transitional care experiences, particularly valuing early self-management support. While these programmes showed potential in promoting positive health outcomes and clinical practices, quantitative evidence supporting their effectiveness is limited, with few experimental studies confirming consistent benefits.
This systematic review highlights the diverse yet fragmented approaches in transitional care for jRMDs, emphasising the need for stronger quantitative evidence. Thus, it is important to conduct further experimental research to optimise existing programmes or develop new ones, ultimately contributing to a smoother transition to adult care and improved long-term outcomes.
综合现有关于青少年起病的风湿性和肌肉骨骼疾病（jRMDs）患者过渡性护理计划的证据，重点关注其结构与实施、相关人员的定性体验和看法，以及与这些计划相关的定量结果。结合其他信息，这些见解为欧洲风湿病协会联盟（EULAR）在过渡性护理期间对jRMDs患者进行体育活动和疼痛自我管理的患者教育要点提供了参考。
进行了一项系统的文献综述，其范围超出了体育活动患者教育和疼痛自我管理，以全面概述风湿病的过渡性护理，旨在优化当前策略、支持循证方法，并确定临床改进领域。检索在PubMed和Cochrane图书馆进行，从建库至2023年11月1日。纳入描述性、定性和定量研究。两名研究人员独立进行检索、筛选、数据提取和质量评估。
从31项研究中，我们确定了18个过渡性护理计划及其关键方法，包括通常整合教育策略的个性化且适合发育阶段的计划。这些计划一般旨在提高转诊准备度、与健康相关的生活质量以及护理连续性，经常涉及多学科团队和早期干预策略。患有jRMDs的青少年及其家庭对这些过渡性护理体验表示满意，尤其重视早期自我管理支持。虽然这些计划在促进积极的健康结果和临床实践方面显示出潜力，但支持其有效性的定量证据有限，很少有实验研究证实一致的益处。
本系统综述强调了jRMDs过渡性护理中多样但零散的方法，强调需要更有力的定量证据。因此，开展进一步的实验研究以优化现有计划或开发新计划很重要，最终有助于更顺利地过渡到成人护理并改善长期结果。
