PT - JOURNAL ARTICLE AU - El Tal, Tala AU - Steiman, Amanda AU - Knight, Andrea AU - Hiraki, Linda T. AU - Levy, Deborah M. AU - Toulany, Alene AU - Silverman, Earl D. TI - Evaluation of a Pediatric-Adult Dyad Care Model for Transitioning Youth With Childhood-Onset Systemic Lupus Erythematosus AID - 10.3899/jrheum.2025-0046 DP - 2025 Nov 01 TA - The Journal of Rheumatology PG - 1151--1158 VI - 52 IP - 11 4099 - http://www.jrheum.org/content/52/11/1151.short 4100 - http://www.jrheum.org/content/52/11/1151.full SO - J Rheumatol2025 Nov 01; 52 AB - Objective Only 50% of pediatric rheumatology patients transition successfully to adult care. We developed a pediatric-adult provider dyad transition model for youth with childhood-onset systemic lupus erythematosus (cSLE). This model transitions patients from the SickKids Transition Clinic (STC) to the Young Adult SLE (YASLE) Clinic at Mount Sinai Hospital (MSH) at age 18, where they receive combined pediatric-adult care for 4 years before transitioning to adult care. We aimed to evaluate the success of this transition model.Methods A retrospective chart review was conducted for patients with cSLE graduating from STC between August 2016 and September 2023. Transition success was assessed using 3 milestones: (1) initial follow-up at the YASLE clinic within 1 year; (2) subsequent follow-up with > 1 YASLE visit; and (3) sustained follow-up at MSH. Data were reviewed as of September 2024.Results Among 234 patients with cSLE, 164 transitioned to the YASLE clinic. At STC, 19.5% had active disease (SLE Disease Activity Index 2000 > 4), and 13.4% had Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) > 1. The first milestone was achieved by 98.2%, with 96.2% attending their first YASLE visit within 1 year (median time 3.5 months). The second milestone was met by 97.5% attending > 1 visit. By the study end, 94.2% of patients maintained care at MSH, with a median follow-up of 5.1 (IQR 2.7-7.1) years, including 45.3% who graduated from YASLE.Conclusion This transition model, incorporating 4 years of combined pediatric-adult care, demonstrated successful transition for youth with cSLE, with > 90% achieving key milestones of initial and sustained follow-up in adult care.Transition care helps teenagers and young adults with long-term health issues like lupus move from pediatric to adult healthcare systems. This process is often difficult, with only 50% successfully making the transitionWe developed a new transition model that starts at The Hospital for Sick Children (SickKids) and moves to the Young Adult Systemic Lupus Erythematosus (YASLE) Clinic at Mount Sinai Hospital when patients turn 18. The unique feature of this model is that patients see both pediatric and adult doctors for 4 years before continuing with only the adult doctor.We reviewed the medical records of all patients with lupus who graduated from SickKids over a 7-year period. Our study showed that this model works well: 98.2% of patients saw the YASLE doctors within a year (usually in about 3.5 months), 97.5% came back for more than 1 visit, and 94.2% kept getting care at MSH for an average of more than 5 years.We suggest that other clinics use this transition model. Key parts of its success are the teamwork and good communication between the pediatric and adult doctors and with patients and their families.