For young patients with rheumatic diseases diagnosed in childhood, moving from pediatric to adult care isn't just a logistical shift — it's an emotionally charged and medically risky transition. Speaking at the Congress of Clinical Rheumatology West, Dr. John M. Bridges of the University of Alabama at Birmingham called this period a "scary time," noting that patients face a convergence of insurance changes, geographic moves, and adherence challenges all at once.

The stakes are high: roughly 50% of pediatric rheumatology patients are lost to follow-up after their very first visit to an adult provider. Bridges emphasized that adult rheumatologists must go beyond simply accepting a new patient — they need to actively engage, understand the patient's full history, and ideally communicate directly with the outgoing pediatric rheumatologist.

Key Takeaways:

• ~50% of transitioning patients are lost to follow-up after their first adult care visit
• Adult rheumatologists should minimize medication changes during the transition period
• First visits should establish trust, clarify role expectations, and open communication channels with pediatric providers
• Asking about insurance, social history, and adherence challenges upfront is critical

Why it matters: With chronic pediatric rheumatic diseases like JIA and childhood-onset lupus requiring lifelong management, losing patients during this transition can lead to disease flares, organ damage, and long-term disability — making a smooth handoff a genuine clinical priority.