POS0293-PARE PROVIDING SUPPORT TO TRANSITION YOUNG ADULTS FROM PEDIATRIC TO ADULT RHEUMATOLOGY: ONE CLINIC’S PERSPECTIVE
Bibliographic record
Abstract
Background: Young adults who transition from pediatric to adult healthcare providers lack adequate support to help them make a successful transfer. Objectives: A needs assessment survey was conducted in Canada in 2021 which identified that the highest priority was “supporting patient education for transition to adult rheumatology health system.” With the establishment of a formal transition clinic, we hoped to empower young adults to independently navigate the healthcare system at our institution. Methods: We set up two transition clinics from January to April 2023. We coordinated with the pediatric rheumatology team to schedule patients into the transition clinics and obtained an IRB from our institution. Inclusion criteria included being 18-25 years old, established with a pediatric rheumatologist, and carrying a rheumatologic diagnosis. Appointments lasted 1.5 hours and included a new patient visit, a session with the social worker and pharmacist, and additional medical education with the rheumatology fellow. The Transition Readiness Assessment Questionnaire (TRAQ) was administered prior to the visit. A modified American College of Rheumatology Self- Care Assessment for Young Adults and an assessment of the transition clinic were given after the visit. Results: Of the six patients recruited into the transition clinic, two patients cited time constraints and declined the additional services. Four patients agreed to move forward with the extended visit, of which two were female and two were male. Three were between the ages of 18-21. One was between the ages of 22-25 years old. All had seen pediatric rheumatology for less than five years. Three had additional visits with their pediatric rheumatologist. The TRAQ survey revealed topics that the patients were most uncomfortable with included navigating health insurance, making a list of questions to ask their doctor, and managing finances. With the modified ACR Self-Care Assessment for Young Adults, patients felt uncomfortable with making refills, giving themselves injectable medications, not requiring anesthesia for joint injections, and treating flares. When evaluating the transition clinic, there was some dissatisfaction regarding addressing smoking, drugs, alcohol, sexual health, insurance, and confidence with disease management. Overall, patients recommended the transition clinic and enjoyed meeting the rheumatology team, learning about their disease and different topics. One patient expressed wanting to learn more about his/her disease. Conclusion: Young adults transitioning from pediatric to adult rheumatology need additional support as they are learning to assume ownership of their medical care. While this trial had a limited patient sample, it identified topics that patients identified being uncomfortable with. The transition clinic is overall a positive experience for patients with additional education time and support from social work and pharmacy. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.059 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".