Pediatric to Adult Rheumatology — a simple, practical transition plan

Switching from a pediatric rheumatologist to adult care feels weird, right? You're not alone. The change can be smooth if you plan ahead. This page gives short, actionable steps you can use now — what to prepare, who to tell, and how to keep your treatment steady.

Start early and make a checklist

Begin planning at least 6–12 months before your first adult appointment. Make a single, easy-to-read checklist: diagnosis, key symptoms and triggers, current meds (generic names, doses), allergy list, recent labs or imaging, and a short treatment summary from your pediatric team. Put all that in a folder or a digital note you can share.

Ask your pediatric provider for a transition summary letter. It should include: diagnosis timeline, which meds worked or didn’t, side effects, recent test results, and a recommended follow-up plan. This saves time and prevents repeating tests.

Practical things to sort out

Insurance and prescriptions often cause the biggest headaches. Check your coverage early — adult providers may require different prior authorizations. If you take disease-modifying drugs (DMARDs) or biologics, ask about refill timing and whether you need pre-approval for injections or infusions.

Know who handles consent and prescriptions where you live. At 18 some places require you to sign for your own care. If you need help, set up a formal caregiver access plan or power of attorney well before the transfer.

Practice speaking up. Adult clinics expect patients to describe symptoms clearly and ask questions. Try writing down three top concerns before each visit: pain control, medication side effects, fertility or pregnancy planning, or work/school limitations. Bring a trusted person to the first few visits if that helps.

Keep a medication journal for 4–6 weeks before the switch: daily dose, how you felt, side effects, sleep, and activity levels. This short log is gold for new doctors and makes medication changes safer.

Learn basic self-management skills. That includes recognizing flare signs, when to call for help, and simple joint care like pacing activity, ice/heat use, and safe stretching. Many adult rheumatology teams expect patients to manage more of these tasks independently.

Finally, use resources. Read concise guides about DMARDs and biologics, or check articles on alternatives if you need medication changes. If you’re moving cities, ask both clinics for recommended adult specialists and transfer of records. A smooth handoff keeps your disease under control and lowers stress.

You don’t have to figure this out alone. Ask your pediatric team for help with referrals, and give yourself time to adjust. One organized folder, a short checklist, and a clear medication list will go a long way.