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Table 3 Transition practices of the respondents

From: Challenges in transitioning adolescents and young adults with rheumatologic diseases to adult Care in a Developing Country - the Brazilian experience

  Answers N (%)
How many patients do you transition per year? <10 patients 34 (44.7)
10–50 patients 41 (54.0)
>50 patients 1 (1.3)
  Answers N (%)
What do you consider the ideal age to start the transition process? <12 years 1 (1.3)
12–14 years 8 (10.5)
15–17 years 46 (60.5)
18–20 years 21 (27.6)
  Answers N (%)
What do you consider the ideal age to transfer patients? 14 years 4 (5.3%)
15–17 years 18 (23.7%)
18 years 33 (43.4%)
19–20 years 11 (14.5%)
> 21 years 10 (13.2%)
  Answers N (%)
Age at which transfer actually happens? 14 years 2 (2.7)
15–17 years 11 (14.5)
18 years 26 (34.2)
19–20 years 23 (30.2)
> 21 years 14 (18.4)
  Answers N (%)
Do you have a transition policy? There is not a formal transition program, but follows an informal protocol to transition patients. 37 (48.7)
There is not a transition program, but there is interest in implementing one. 27 (35.5)
There is a formal transition program, well-established and structured. 10 (13.1)
Transition program under development. 10 (13.1)
The transition has not been discussed. 3 (4.0)
There is no need for a transition program at this time. 1 (1.3)
  Answers N (%)
How do you prepare your patients for transition? Patient’s knowledge assessment about their own illness, current and past treatments. 50 (65.8)
Prior visit with an adult rheumatology from the center where the patient will be taken. 48 (63.2)
Discussion on education, vocation and finding a job. 21 (27.6)
Patients are assisted by social worker and/or psychologist. 13 (17.1)
Patient’s knowledge assessment about their health insurance. 11 (14.5)
  Answers N (%)
How do you facilitate the transition process? Provide a medical summary of the disease to the patient and/or the center where the patient will be followed. 66 (86.8)
Schedule the first visit for the patient in the center of adult rheumatology. 30 (39.5)
Provide copy of the patient’s records. 20 (26.3)
Development of an individual transition plan. 9 (11.8)
Provide a map with instructions of how to get to the center of adults where the patient will be followed. 8 (10.5)
Provide instruction on the health insurance. 7 (9.2)
Flyers/educational materials. 6 (7.9)
We do not provide any material. 3 (3.9)
Other practices. 8 (10.5)
  Answers N (%)
Do you use any tools for transition? No tools. 63 (82.9)
Checklist with objectives to be met by the time of transition. 10 (13.2)
Protocols that assess the patient’s readiness for transition. 7 (9.2)
  Answers N (%)
What influences the decision to transfer? Age of the patient. 73 (96.1)
Patient request for transition. 28 (36.8)
Transition patients in order to have place for new patients. 23 (30.3)
Patient’s family request for transition. 22 (28.9)
Patient’s disease activity. 20 (26.3)
Patient having children/starting a family. 15 (19.7)
Private health insurance status. 8 (10.5)
Distance between the patient’s residence and its rheumatology center. 7 (9.2)
Patient getting a job. 5 (6.6)
  Answers N (%)
Who makes the final decision when to transfer the patient? The doctor 62 (81.6)
The patient 4 (5.3)
The family of the patient 1 (1.3)
Others 9 (11.8)
  Answers N (%)
Where do you transfer your patients to? Adult rheumatology tertiary center linked to the same pediatric rheumatology center. 57 (75.0)
Secondary specialized medical center not linked to the original center 16 (21,0)
Private rheumatologist 15 (19.7)
Patient/family find themselves a specialist 5 (6.6)
Other 12 (15.8)
  Answers N (%)
How many times do you allow your patients to return to the pediatric rheumatology center after the transition? One return. 47 (61.8)
More than one return. 9 (11.9)
No returns. 20 (26.3)