{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:26:48Z","timestamp":1785554808216,"version":"3.56.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The chronicity and severity of childhood-onset systemic lupus erythematosus (cSLE) necessitate effective transition from pediatric to adult providers. We studied transition outcomes in a cSLE cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified patients at an adult lupus clinic diagnosed with SLE\u2009\u2264\u200918 years who had been followed by a pediatric rheumatologist. Data extracted from the first three years in adult care (\u201cpost-transition period\u201d) included: sociodemographics, depression, anxiety, SLE manifestations, SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics\/ACR Damage Index for SLE (SLICC) scores, non-adherence, and gaps in care (no appointments in the recommended time frame). Multivariable logistic regression analyses for predictors of: (1) time between pediatric and adult providers, (2) gaps in care, (3) unscheduled utilization (emergency department visits and admissions) (4) depression and\/or anxiety were performed, as was a multivariable Poisson regression analysis for number of missed appointments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 50 patients, SLEDAI scores were stable (mean 5.7\u2009\u00b1\u20095.0 at start vs. 4.7\u2009\u00b1\u20094.8 at year 3, p\u2009=\u20090.2), but SLICC scores increased (0.46\u2009\u00b1\u20090.84, vs. 0.78\u2009\u00b1\u20091.25, p\u2009=\u20090.01). Depression and anxiety increased significantly (10% vs. 26%, p\u2009=\u20090.02). Mean time from last pediatric to first adult provider visit was almost nine months (253\u2009\u00b1\u2009392 days). Nearly 75% of patients had\u2009\u2265\u20091 gap in care. White race, low education level and non-adherence were significantly associated with missed appointments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite moderate disease activity in this cSLE transition cohort, prolonged time between pediatric and adult providers and gaps in care in the post-transition period occurred. Anxiety and depression were frequently reported. Future work should identify methods to improve transition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0961203316640913","type":"journal-article","created":{"date-parts":[[2016,3,24]],"date-time":"2016-03-24T20:58:00Z","timestamp":1458853080000},"page":"1431-1439","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":66,"title":["Disease activity and transition outcomes in a childhood-onset systemic lupus erythematosus cohort"],"prefix":"10.1177","volume":"25","author":[{"given":"M B","family":"Son","sequence":"first","affiliation":[{"name":"Division of Immunology, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Sergeyenko","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Guan","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Immunology, and Allergy, Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KH","family":"Costenbader","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Immunology, and Allergy, Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,11]]},"reference":[{"key":"bibr1-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1186\/ar4256"},{"key":"bibr2-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328323daad"},{"key":"bibr3-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1640"},{"key":"bibr4-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-0969"},{"key":"bibr5-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.S3.1304"},{"key":"bibr6-0961203316640913","unstructured":"Healthy People 2020 Topics and Objectives, Disability and Health https:\/\/www.healthypeople.gov\/2020\/topics-objectives (accessed 24 August 2015)."},{"key":"bibr7-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3050"},{"key":"bibr8-0961203316640913","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-7-200410050-00009"},{"key":"bibr9-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-7-13"},{"key":"bibr10-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22611"},{"key":"bibr11-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780251101"},{"key":"bibr12-0961203316640913","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090862"},{"key":"bibr13-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780350606"},{"key":"bibr14-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390303"},{"key":"bibr15-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201937"},{"key":"bibr16-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.24.2755"},{"key":"bibr17-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2013.11.007"},{"key":"bibr18-0961203316640913","first-page":"490","volume":"26","author":"Strand V","year":"1999","journal-title":"J Rheumatol"},{"key":"bibr19-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02521.x"},{"key":"bibr20-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1002\/art.10790"},{"key":"bibr21-0961203316640913","unstructured":"Transition CfHC. Six Core Elements of Health Care Transition. http:\/\/www.gottransition.org\/resources\/index.cfm 2015."},{"key":"bibr22-0961203316640913","doi-asserted-by":"publisher","DOI":"10.4158\/EP13109.OR"},{"key":"bibr23-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0249"},{"key":"bibr24-0961203316640913","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0087"},{"key":"bibr25-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313488840"},{"key":"bibr26-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313477227"},{"key":"bibr27-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1002\/art.39111"},{"key":"bibr28-0961203316640913","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110771"},{"key":"bibr29-0961203316640913","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2830"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203316640913","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0961203316640913","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203316640913","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:16:52Z","timestamp":1777677412000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0961203316640913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,11]]},"references-count":29,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1177\/0961203316640913"],"URL":"https:\/\/doi.org\/10.1177\/0961203316640913","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,11]]}}}