Clinic helps young patients transition from pediatric to adult rheumatology care

"When you are between 18 and 25, there’s a lot going on in your life – school, first apartment, love, friends, etc. – so following strict medical treatments might not always be your first priority,” says Dr. Elizabeth Hazel, MUHC rheumatologist and associate professor of medicine at the Montreal General Hospital (MGH) of the McGill University Health Centre (MUHC). “That’s why at the YARD (Young Adults Rheumatologic Diseases) Clinic, we are more flexible and accommodating with our patients about things like missed appointments.”

 

During her fellowship, Dr. Hazel conducted a study from which she identified a niche of patients who didn’t have a place to go after they left the Montreal Children’s Hospital (MCH). “There’s a big difference about how rheumatic care is given between pediatric and adult hospitals. From a multidisciplinary approach at the MCH to more of a one-on-one intervention at the MGH, a lot of young patients stop going to their appointments because nobody chases after them in the adult sites like they do at The Children’s,” adds Dr. Hazel. Her study results were devastating: half of the young patients who needed care got lost in the transition process. 

 

In order to improve this distressing statistic, Dr. Hazel opened the YARD Clinic in 2007. With now over 200 patients, it seems the need for such a specialized clinic was critical. “The way Quebec’s health system works, there are a lot more resources available in pediatric than the adult system in terms of occupational therapy, social work and physiotherapy, for example,” she explains. But thanks to a partnership with the Constance-Lethbridge Rehabilitation Centre, the YARD Clinic is now able to offer its patients all sorts of services they might need because of the deformities or handicaps caused by their condition. 

 

Another big project underway at the Clinic is the search for ways to identify if a patient is ready for the transition from pediatric to adult care. With colleagues from all across Canada, Dr. Hazel is formulating a questionnaire that can be given to 15- or 16-year-olds to see where their gaps in knowledge are so the Clinic can better prepare these patients for their transition. They are also producing teaching modules for different ages to get young patients ready for situations like describing their disease to someone in the Emergency Department or to a teacher or boss.