• Semin. Arthritis Rheum. · Oct 2017

    Transition to adult rheumatology care is necessary to maintain DMARD therapy in young people with juvenile idiopathic arthritis.

    • Andres Luque Ramos, Falk Hoffmann, Katinka Albrecht, Jens Klotsche, Angela Zink, and Kirsten Minden.
    • Department of Health Services Research, Carl von Ossietzky University, Oldenburg, Ammerländer Heerstrasse 140, 26111, Germany. Electronic address: andres.luque.ramos@uni-oldenburg.de.
    • Semin. Arthritis Rheum. 2017 Oct 1; 47 (2): 269-275.

    ObjectiveTo evaluate the outpatient health service utilisation of young people (YP) with juvenile idiopathic arthritis (JIA) during transfer from paediatric to adult care in Germany.MethodsBased on claims data of a large German statutory health fund (BARMER GEK) we conducted a cohort study of 2008-2014. Insured YP with diagnosis of JIA (ICD: M08 or M09.0) in two quarters at the age of 16 and continuous insurance until the age of 20 were included. Outpatient health care utilisation, prescribed antirheumatic drugs and diagnosis maintenance were analysed over four consecutive years for all YP with JIA and for the subgroup on disease-modifying antirheumatic drugs (DMARDs) at the age of 16.ResultsA total of 256 YP with JIA (67% female) were followed during the transfer period, 115 of them received (DMARDs) at the age of 16. At the age of 20, 30% of all 256 YP utilised adult specialty care, 59% still had a JIA diagnosis and 30% were treated with DMARDs. Of those 115 YP, treated with DMARDs at the age of 16 and in need of follow-up, 49% had visited an adult rheumatologist at the age of 20, 75% had a JIA diagnosis and 56% were on DMARDs. Those 49% YP with successful transfer to adult specialty care had a JIA diagnosis in 93% and were treated with DMARDs in 80%. YP, who were only seen by general practitioners, had a JIA diagnosis in 54% and received DMARDs in 27%.ConclusionsOne in two YP with JIA and a clear need for ongoing follow-up do not utilise adult rheumatologic care. The maintenance of JIA diagnosis and DMARD therapy depend on the utilisation of specialised care services.Copyright © 2017 Elsevier Inc. All rights reserved.

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