Three decades of health care transition in rheumatology: Progress, challenges, and future directions

The revolution of treatment advances for children with rheumatic diseases since the advent of pediatric rheumatology has coincided with the growing recognition that many of these children will continue to require long-term rheumatology care after reaching adulthood. Moreover, it has become evident that effective, systematic approaches are needed to help adolescents and young adults (AYA) with pediatric rheumatic diseases learn to manage their health independently and succeed in an adult-oriented model of health care. In this narrative literature review, we provide a historical perspective on health care transition and its relevance to the field of rheumatology. Second, we review seminal literature on outcomes of transition and transition-related needs of AYA with pediatric-onset rheumatic diseases. Third, we describe interventions designed to improve health care transition for AYA with pediatric rheumatic diseases. Lastly, we discuss remaining knowledge gaps and future directions for the field.