Transition of adolescents with JIA to adult rheumatology: what is the most suitable time?

INTRODUCTION/OBJECTIVES: Improved long term outcomes in juvenile idiopathic arthritis (JIA) have increased the demand for transition to adult rheumatology care [1]. There is a need for evaluation criteria that can be used in this process. In this study, the Transition Readiness Assessment Questionnaire (TRAQ) was applied to patients with JIA to identify clinical factors associated with transition readiness and determine most appropriate time frame for transition. METHOD: This cross-sectional study included 115 adolescents with JIA followed in the Department of Pediatric Rheumatology at Dokuz Eylül University between 2021 and 2023. Patients were divided into two age groups (14-15 and 16-18 years) to compare TRAQ scores and demographic, clinical characteristics. TRAQ scores were categorized by percentile values; multivariable logistic regression and ROC analyses were performed to identify independent predictors and the age associated with high transition readiness. RESULTS: Among 115 adolescents with JIA, 54 (47%) were aged 14-15 years and 61 (53%) were aged 16-18 years; 58 (50.4%) were female. Total TRAQ and subscale scores were significantly higher in the 16-18 age group, except for the "tracking health issues" subscale. In multivariate analysis, age was the only independent predictor associated with both high and low TRAQ scores. ROC analysis identified 17.5 years as the optimal cutoff value for predicting high TRAQ scores. CONCLUSIONS: Although transition readiness increased with age and was higher in patients aged 16-18 years, initiating transition education at age 14 may support a more effective transition process, reduce transition related anxiety and improve follow-up quality. Key Points • Transition readiness was significantly higher in adolescents aged 16-18 years, with age as the strongest independent predictor of TRAQ scores. • The findings support early transition education beginning around the age of 14 years in adolescents with JIA. • ROC analysis identified 17.5 years as the age most strongly associated with higher transition readiness.