Transition: Moving from Pediatric to Adult Rheumatology Care

Life is in a constant state of transition, from infancy through childhood to adolescence and adulthood. Continuity of medical care through the early years is usually provided by the primary care physician and pediatrician, and in the case of the child with a rheumatic disease, ideally by the pediatric rheumatologist. The care is family centered and relies to a great extent on the participation of the parents as well as the child. During adolescence, however, medical care is increasingly the responsibility of the patient and eventually changes from the pediatric setting to the adult setting. Management of this period of transition is vitally important to the adolescent child with a chronic disease requiring ongoing specialist care. Adolescence is a period in which biological, psychological, and social changes occur at a rapid pace; chronic diseases, such as the rheumatic diseases, have significant impact on the normal adolescent growth and development and, in turn, are influenced by the normal evolution of psychological and social changes in the individual during this time.