Transition Success Score Developed for Pediatric Rheumatology
TRANSITION success score provides a patient level metric to evaluate outcomes as adolescents move from pediatric to adult care. Although several tools assess readiness for transition, few measures exist to determine whether the transition itself is successful. This lack of standardized assessment has limited clinicians’ ability to evaluate the effectiveness of structured transition programs.
The score incorporates four components that account for one quarter of the total transition success score, each reflecting a key milestone of successful transition. Researchers calculated scores through retrospective electronic medical record (EMR) review.
These include attending the first adult rheumatology appointment within the timeframe recommended by the pediatric rheumatologist, refilling medications with the adult provider within 3 months of that visit, avoiding rheumatology related emergency department visits during the first year after transition, and attending a second adult rheumatology appointment.
Cohort Analysis Reveals Moderate Transition Outcomes
The transition success score was applied to a cohort of patients identified between 2017–2024 who had a final visit with pediatric rheumatology. Investigators identified 357 patients through provider notification and EMR review. Transition success scores were achieved by 198 patients.
Optimal transition success defined as achievement of all four components was observed in 72/198 patients (36%). An additional 77/198 patients (39%) achieved a score of 75%. Only 3/198 patients (1.5%) scored 0%.
Component level analysis demonstrated variable performance across transition milestones. Attendance at the first adult appointment occurred in 113 patients (57%). Medication refills with an adult provider within 3 months were documented for 150 patients (76%). Avoidance of rheumatology related emergency department visits during the first year was achieved by 165 patients (83%). Attendance at a second adult appointment occurred in 159 patients (80%).
Opportunities To Strengthen Transition Programs
Although most patients met at least three components of the transition success score, investigators identified areas requiring improvement. Notably, documentation confirming attendance at a second adult rheumatology visit was unavailable for 39/198 patients, representing the 20% cohort.
Researchers suggest that applying the transition success score alongside additional measures such as patient reported readiness for transition or the use of transition summary letters may help identify predictors of successful transfer to adult care.
Future work will evaluate how specific transition program elements influence the transition success score, with the goal of improving long term continuity of care for pediatric rheumatology patients.
Reference
Blasingame K et al. A novel score for transition success of pediatric rheumatology patients. Health Care Transit. 2026;DOI: 10.1016/j.hctj.2026.100130;4:100130.
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