Barriers affecting the provision of transition support services in pediatric rheumatology practices with comparisons to American Academy of Pediatrics (AAP) responses (noted in parentheses).
| Barriers | Major Barrier | Somewhat of a Barrier |
|---|---|---|
| Pediatric staff lack sufficient time to provide transition services | 37% (36%) | 41% (45%) |
| Fragmentation of primary and specialty care in adult care | 35% (39%) | 41% (46%) |
| Adolescents/parents/physicians have developed an effective bond that is hard to break | 30% (32%) | 54% (58%) |
| Adolescents’ lack of knowledge about their own condition and/or skills to self-advocate at physician visits | 28% (19%) | 56% (65%) |
| Pediatric staff lack skills in transition planning | 26% (33%) | 47% (46%) |
| Lack of knowledge about or linkages to community resources that support older adolescents/young adults | 24% (39%)* | 54% (49%) |
| Lack of available adult specialists to care for older adolescents/young adults with special needs | 24% (40%)* | 44% (38%) |
| Lack of insurance reimbursement for transition services | 23% (38%)* | 35% (38%) |
| Lack of available family physicians and internal medicine physicians to care for older adolescents/young adults with special needs | 22% (41%)* | 41% (39%) |
Many barriers exist for pediatric rheumatology providers, but insufficient time, fragmentation of adult care services, and difficulty to break bonds are cited as the top major barriers for CARRA respondents. Comparisons with AAP respondents showed statistically significant differences,
↵* p < 0.001, in major barriers for lack of providers, knowledge, and reimbursement.