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Navigating Complexities of Juvenile Arthritis Care Transition to Adulthood, with Karen Onel, MD
July is Juvenile Arthritis Month and Onel discussed complexities of transitioning care.
Arthritis is the number one cause of disability in the U.S. and affects hundreds of thousands of kids and teens, impacting their daily lives, education and overall mental and physical well-being. JIA is often marginalized next to more common adult rheumatological diseases such as rheumatoid arthritis and psoriatic arthritis, while the etiological differences between JIA and these adult diseases are still not fully understood. The Arthritis Foundation is proudly focused on raising awareness of its resources for children and families living with juvenile arthritis, especially during July’s Juvenile Arthritis Awareness Month. JA initiatives include advocacy around the severe nationwide shortage of pediatric rheumatologists.
While advances in care have drastically improved the outlook for children with JA, a major hurdle remains: the transition from pediatric to adult rheumatology. Unlike other diseases that have clearly defined diagnostic criteria across age groups, JA exists in a complicated space, both medically and administratively. As pediatric patients grow older, the name, classification, and even approved treatments for their condition often change, creating confusion for patients, parents, and providers alike.
To explore the complexities of these issues, HCPLive spoke with an expert of pediatric rheumatology Karen Onel, MD, Chief, Division of Pediatric Rheumatology at Hospital of Special Surgery, and Professor of Clinical Pediatrics at Weill Cornell Medicine.
"There's a lot of work that has to be done, and many people have come up with many different ways. It's definitely not one size fits all, and it's something we just have to continue to chip away at and make sure that our patients get seen and all these different issues are paid attention to, but it's complicated and very nuanced," Onel said.
Onel unpacked the many layers of the messy JA transition process from childhood to adulthood, from gaps in training among adult providers to systemic issues like insurance changes and loss of follow-up. She also addresses the often-overlooked role of parents in managing care during early adulthood and how shifting communication dynamics can lead to missed care. As more patients with JA age into adulthood, these challenges are increasingly urgent. Understanding them is the first step toward ensuring continuity of care and healthier long-term outcomes.
Onel has no relevant disclosures to report.
