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Joint Bone Spine. 2018 Jul;85(4):435-440. doi: 10.1016/j.jbspin.2017.09.003. Epub 2017 Sep 28.

Building a transitional care checklist in rheumatology: A Delphi-like survey.

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Institute of social and preventive medicine, Lausanne university hospital, 10, route de la Corniche, 1010 Lausanne, Switzerland. Electronic address:
Institute of social and preventive medicine, Lausanne university hospital, 10, route de la Corniche, 1010 Lausanne, Switzerland.
Pediatric nephrology, rheumatology, dermatology unit, hospices civils de Lyon, Institut national de la santé et de la recherche médicale, 69002 Lyon, France.
Adult rheumatology unit, Lausanne university hospital, 1011 Lausanne, Switzerland.
Department of paediatrics, Geneva university hospital, 1211 Geneva, Switzerland.
Rheumatology and pediatric immunology, Geneva League against rheumatism, 1207 Geneva, Switzerland.
Internal medicine department, National reference center of familial mediterranean fever and inflammatory amyloïdosis, Tenon hospital, 75020 Paris, France; Université Pierre-et-Marie-Curie, 75020 Paris, France.
Rheumatology department, Lyon Sud hospital, hospices civils Lyon, 2016 Lyon, France.
Rheumatology practice, 88662 Ueberlingen, Germany.
Primary care unit, faculty of medicine, Geneva university hospital, 1211 Geneva, Switzerland.
Dr. von Hauner children's hospital, Ludwig Maximilian university, Rheumatology at Endokrinologikum, 80539 Munich, Germany.
Unité romande d'immuno-rhumatologie pédiatrique, Lausanne university hospital, Geneva university hospital, 1011 Lausanne, Switzerland.



To design a transitional care checklist to be used by and facilitate the work of health professionals in providing transitional care for children with a chronic rheumatologic disease and their families.


A Delphi-like study among an international expert panel was carried out in four steps: (1) a working group of 6 specialists established a draft; (2) a web-survey among a panel of international experts evaluated it; (3) a 2-day consensus conference with an expert panel discussed items not reaching agreement; (4) a web-survey among the panel of international experts with the list of reformulated items.


The first draft of the checklist included 38 items in 3 phases of transition and 5 age groups. Thirty-three international experts evaluated the checklist reaching≥80% agreement for 26 items and ≤80% for 12. The consensus conference of 12 experts discussed and redefined the 12 items. Twenty-five international experts filled out the web-survey and all items reached a minimum of 80% agreement except one. The final checklist was reached.


This Delphi-like study defined what themes should be included and at what age they need to be addressed with patients with a chronic rheumatology disease and their families during transition. This checklist reached a strong international and interdisciplinary consensus while examining transition in a broad way. It should now be spread widely to health professionals to be used by all those who care for adolescents aged≥12 years at times of transition. It could be transposed to most chronic conditions. Recommendations for further research are given.


Adolescent; Checklist; Chronic condition; Delphi study; Transition

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