T2T: Treat To Target for Kids With Juvenile Idiopathic Arthritis

What is Treat to Target (T2T)?

Treat to Target is a name for one of the ways we take care of kids who have juvenile idiopathic arthritis (JIA) to get better results. T2T works by making providers, patients, and their care-givers partners in setting goals.   The first step is when everyone on the team talks about treatment goals and personal goals.  When everyone agrees on goals, they can work together to make a plan.  This helps patients feel like they have more control.  The hope is that patients will be more active and happy.  Their disease can get better, the side effects from medicine can get better, and other sicknesses might be avoided or get better.

How is it Different from Usual Care?

Treat to Target is different from what most JIA patients, caregivers, and providers, are used to.  In the past, providers were the ones making all of the decisions and patients mostly followed that plan.  This way of doing things may feel new to JIA patients, but it’s already being used in other medical conditions, such as high blood pressure, diabetes, and adult arthritis – with great results!

What will Happen at My Appointments?

For many patients, inactive disease is the target.  This means that there are no signs and symptoms of JIA (such as swollen joints, pain, or stiffness).  For some patients, inactive disease is harder to reach, so they may set a goal of low disease activity (things like swelling, pain, and stiffness will happen less often and be easier to handle).  In addition to deciding on a treatment target, more personal goals should be set, such as going to school more often, playing sports, or being creative.

When the patient visits the provider or care team, they will talk about how the patient is doing.  They will then choose goals, or “targets”, together.  Everyone on the team has a job while using T2T.  Patients and caregivers must be honest about their needs and wants.  They must also be honest with the provider or team about how well they are following their treatment plan, including taking their medicine.  The care team must be able to listen to the patient about what is important to them.  Together, they will come up with a plan to reach their target, and do their best to stick to the plan.

What Happens Next?

When following T2T, we want most patients to be 50% better within three months and reach their target within six months.  Medical staff will keep track of how well the patient is doing at each appointment.  If it seems like the patient is not “at target,” the team will work together to figure out why and come up with a new plan.  This might mean changing the dose of medicine, how often they take the medicine, or even trying new medicine. If a patient reaches their target, they will talk to their provider about how long they should stay on the plan.  Sometimes patients can take less medicine or stop taking it after they have been at their target for a while.  It’s important to remember that there is no way to know if a patient’s disease will stay inactive or for how long.  If the JIA comes back, the Treat to Target process will start again.  Everyone will keep working hard – together – to make every JIA patient feel as well as they can!

Read more about JIA remission. Sign up for the Live Yes! Online Community and join the discussion on the JA Families forum to share and learn about remission and Treat to Target.  It’s free!

Learn more about childhood arthritis, educational and social opportunities and other available resources through the Lives Yes! Arthritis Network.


©Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) https://pr-coin.org/

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