1
|
Eid R, Hammad A, Korkor MS, Fathy AA, Abd El-Ghafaar DM, Rakha S, Hamdy N. Health Related Quality of Life in Juvenile-Onset Systemic Lupus Erythematosus: A Questionnaire-Based Study. Matern Child Health J 2023:10.1007/s10995-023-03680-x. [PMID: 37308717 DOI: 10.1007/s10995-023-03680-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to evaluate health related quality of life (HRQOL) in Egyptian children with systemic lupus erythematosus (SLE) using 3 different tools. METHODS In this questionnaire-based study, 100 children with SLE were included. HRQOL was assessed using the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL™ 4.0 GCS), PedsQL™ 3.0 Rheumatology Module (PedsQL3-RM) and the Simple Measure of the Impact of Lupus Erythematosus in Youngsters (SMILEY). SLE disease activity index (SLEDAI) was used to evaluate activity and SLE International Collaborating Clinics/ American College of Rheumatology Damage Index (SDI) was used to evaluate chronic damage. RESULTS All mean scores of PedsQLTM4.0 GCS domains in SLE patients were lower than published normative data and previously published results of Egyptian healthy controls (p < 0.001). All mean scores of PedsQL-3RM domains were significantly lower than published normative data except for the treatment and pain and hurt domains (p = 0.1, 0.2 respectively). SMILEY scores were low and the lowest domain scores was "Burden of SLE". Longer duration of illness, higher cumulative steroid doses, higher SLEDAI and SDI scores and presence of obesity were associated with lower scores for all 3 tools (p < 0.001). CONCLUSION FOR PRACTICE The Arabic copies of PedsQL™ 4.0 GCS, PedsQL3-RM and SMILEY are easily used for Arabic speaking subjects and easily interpreted by physician and can be implemented for frequent monitoring of SLE HRQOL. Controlling the disease activity and using lowest doses of steroids and other immunosuppressive drugs are the corner stone strategies for improving HRQOL in SLE children.
Collapse
Affiliation(s)
- Riham Eid
- Pediatric Nephrology Unit, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura University, Mansoura, 35561, Egypt.
| | - Ayman Hammad
- Pediatric Nephrology Unit, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura University, Mansoura, 35561, Egypt
| | - Mai S Korkor
- Pediatric Nephrology Unit, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura University, Mansoura, 35561, Egypt
| | - Aya A Fathy
- Public Health and Community Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Dena M Abd El-Ghafaar
- Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Shaimaa Rakha
- Pediatric Cardiology Unit, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura University, Mansoura, Egypt
| | - Nashwa Hamdy
- Pediatric Nephrology Unit, Faculty of Medicine, Mansoura University Children's Hospital, Mansoura University, Mansoura, 35561, Egypt
| |
Collapse
|
2
|
Oen K, Tian J, Loughin TM, Shiff NJ, Tucker LB, Huber AM, Berard RA, Levy DM, Rumsey DG, Tse SM, Chan M, Feldman BM, Duffy CM, Guzman J. Causal pathways to health-related quality of life in children with juvenile idiopathic arthritis: results from the ReACCh-Out cohort. Rheumatology (Oxford) 2021; 60:4691-4702. [PMID: 33506861 DOI: 10.1093/rheumatology/keab079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/04/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Structural equation modelling was applied to data from the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) cohort to help elucidate causal pathways to decreased health-related quality of life (HRQoL) in children with JIA. METHODS Based on published literature and clinical plausibility, a priori models were constructed with explicit root causes (disease activity, treatment intensity) and mediators (pain, disease symptoms, functional impairments) leading to HRQoL [measured by the Quality of my Life (QoML) scale and the Juvenile Arthritis Quality of Life Questionnaire (JAQQ)] at five disease stages: (i) diagnosis, (ii) 3-9 months after diagnosis, (iii) flare, (iv) remission on medications, (v) remission off medications. Following structural equation modelling, a posteriori models were selected based on data fit and clinical plausibility. RESULTS We included 561, 887, 137, 186 and 182 patients at each stage, respectively. In a posteriori models for active disease stages, paths from disease activity led through pain, functional impairments, and disease symptoms, directly or through restrictions in participation, to decreased QoML scores. Treatment intensity had detrimental effects through psychosocial domains; while treatment side effects had a lesser role. Pathways were similar for QoML and JAQQ, but JAQQ models provided greater specificity. Models for remission stages were not supported by the data. CONCLUSION Our findings support disease activity and treatment intensity as being root causes of decreased HRQoL in children with JIA, with pain, functional impairments, and participation restrictions being mediators for disease activity; they support psychosocial effects and side effects as being mediators for treatment intensity.
Collapse
Affiliation(s)
- Kiem Oen
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba
| | - Jiahao Tian
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia
| | - Thomas M Loughin
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia
| | - Natalie J Shiff
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Lori B Tucker
- Division of Pediatric Rheumatology, British Columbia Children's Hospital.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam M Huber
- Division of Pediatric Rheumatology, IWK Health Centre and Dalhousie University, Halifax, Nova Scotia
| | - Roberta A Berard
- Pediatric Rheumatology, Children's Hospital, London Health Sciences Centre, London
| | - Deborah M Levy
- Division of Rheumatology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario
| | - Dax G Rumsey
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Shirley M Tse
- Division of Rheumatology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario
| | - Mercedes Chan
- Division of Pediatric Rheumatology, British Columbia Children's Hospital.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian M Feldman
- Division of Rheumatology, The Hospital for Sick Children and Departments of Pediatrics, Medicine, and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto
| | - Ciaran M Duffy
- Children's Hospital of Eastern Ontario and Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Jaime Guzman
- Division of Pediatric Rheumatology, British Columbia Children's Hospital.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | | |
Collapse
|
3
|
Leo DG, Perry DC, Abdullah B, Jones H. PROMIS Paediatric Mobility tool is correlated with accelerometer-measured physical activity in children with hip diseases. Bone Joint J 2021; 103-B:405-410. [PMID: 33517720 DOI: 10.1302/0301-620x.103b2.bjj-2020-0744.r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIMS The reduction in mobility due to hip diseases in children is likely to affect their physical activity (PA) levels. Physical inactivity negatively influences quality of life and health. Our aim was to objectively measure PA in children with hip disease, and correlate it with the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Score. METHODS A total of 28 children (12 boys and 16 girls) with hip disease aged between 8and 17 years (mean 12 (SD 3)) were studied between December 2018 and July 2019. Children completed the PROMIS Paediatric Item Bank v. 2.0 - Mobility Short Form 8a and wore a hip accelerometer (ActiGraph) for seven consecutive days. Sedentary time (ST), light PA (LPA), moderate to vigorous PA (MVPA), and vigorous PA were calculated from the accelerometers' data. The PROMIS Mobility score was classified as normal, mild, and moderate functions, based on the PROMIS cut scores on the physical function metric. A one-way analysis of covariance (ANCOVA) was used to assess differences among mobility (normal; mild; moderate) and measured PA and relationships between these variables were assessed using bivariate Pearson correlations. RESULTS Children classified as normally functioning on the PROMIS had less ST (p = 0.002), higher MVPA, (p = 0.002) and VPA (p = 0.004) compared to those classified as mild or moderate function. A moderate correlation was evident between the overall PROMIS score and daily LPA (r = 0.462, n = 28; p = 0.013), moderate-to-vigorous PA (r = 0.689, n = 28; p = 0.013) and vigorous PA (VPA) (r = 0.535, n = 28; p = 0.013). No correlation was evident between the mean daily ST and overall PROMIS score (r = -0.282, n = 28; p = 0.146). CONCLUSION PROMIS Pediatric Mobility tool correlates well with experimentally measured levels of physical activity in children with hip disease. We provide external validity for the use of this tool as a measure of physical activity in children. Cite this article: Bone Joint J 2021;103-B(2):405-410.
Collapse
Affiliation(s)
- Donato Giuseppe Leo
- School of Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel C Perry
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Alder Hey Children's Hospital, Institute in the Park, Liverpool, UK
| | - Badr Abdullah
- Built Environment and Sustainable Technology (BEST) Research Institute, Liverpool John Moores University, Liverpool, UK
| | - Helen Jones
- School of Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
4
|
Treemarcki EB, Hersh AO. Health-Related Quality of Life Measures in Childhood-Onset Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:593-607. [PMID: 33091261 DOI: 10.1002/acr.24374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 11/11/2022]
Affiliation(s)
| | - Aimee O Hersh
- University of Utah and Primary Children's Hospital, Salt Lake City
| |
Collapse
|
5
|
Ganguli SK, Hui-Yuen JS, Jolly M, Cerise J, Eberhard BA. Performance and psychometric properties of lupus impact tracker in assessing patient-reported outcomes in pediatric lupus: Report from a pilot study. Lupus 2020; 29:1781-1789. [DOI: 10.1177/0961203320951264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To evaluate the reliability, validity, feasibility and psychometric performance of the Lupus Impact Tracker (LIT) as a patient reported outcome (PRO) measure tool in pediatric systemic lupus erythematosus (pSLE). Methods This is a prospective, observational, pilot study where patients aged between 12 and 25 years, fulfilling the 1997 ACR classification criteria for SLE, were enrolled. Over 3 consecutive, routine, clinical visits, the patients completed the LIT alongside the Patient-Reported Outcomes Measurement Information System-Short Forms (PROMIS-SFs), Childhood Health Assessment Questionnaire (CHAQ). Rheumatologists completed the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC-ACR) Damage Index. Demographic, clinical and laboratory data were also collected. Results Of 46 patients enrolled, 38 patients completed 2 visits and 31 completed all 3 visits. Seventy-eight percent were female, 33% African American, 28% Asian, 15% Caucasian and 17% Hispanic. The mean (SD) age was 17.2 (2.7) years, with a mean (SD) disease duration of 4.6 (3.1) years. The mean (SD) SLEDAI-2K at enrollment was 3.54 (2.96). In the 38 patients who completed two or more visits, intra-class correlation coefficient and Cronbach alpha were calculated to be 0.70 and 0.91 respectively, signifying good reliability of LIT. The LIT showed positive correlation with CHAQ-Disability Index and majority of the PROMIS-SFs parameters. Construct validity was established against clinical disease activity (SLEDAI-2K). Conclusion The preliminary results indicate that the LIT is a reliable and valid instrument to capture PRO in p-SLE. Prospective validation with a larger, multicenter cohort is the next step.
Collapse
Affiliation(s)
- Suhas K Ganguli
- Department of Pediatric Rheumatology, Marshfield Clinic, Marshfield, WI, USA
| | - Joyce S Hui-Yuen
- Department of Pediatric Rheumatology, Cohen Children’s Medical Center, Lake Success, NY, USA
- Department of Pediatrics, School of Medicine, Hofstra University, Hempstead, NY, USA
| | - Meenakshi Jolly
- Department of Rheumatology, Rush University Medical Center, Chicago, IL, USA
| | - Jane Cerise
- Department of Biostatistics, The Feinstein Institute of Medical Research, Manhasset, NY, USA
| | - Barbara Anne Eberhard
- Department of Pediatric Rheumatology, Cohen Children’s Medical Center, Lake Success, NY, USA
- Department of Pediatrics, School of Medicine, Hofstra University, Hempstead, NY, USA
| |
Collapse
|
6
|
A prediction rule for lack of achievement of inactive disease with methotrexate as the sole disease-modifying antirheumatic therapy in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:50. [PMID: 31345226 PMCID: PMC6657374 DOI: 10.1186/s12969-019-0355-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/16/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To investigate the frequency of achievement of inactive disease (ID) in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX) as the sole disease-modifyng antirheumatic (DMARD) therapy and to develop a prediction model for lack of attainment of ID. METHODS The clinical charts of consecutive patients started with MTX as the sole DMARD between 2000 and 2013 were reviewed. Patient follow-up was censored at first episode of ID or, in case ID was not reached, at last follow-up visit or when a biologic DMARD was prescribed. The characteristic at MTX start of patients who achieved or did not achieve ID were compared with univariate and multivariable analyses. Regression coefficients (β) of variables that entered the best-fitting logistic regression model were converted and summed to obtain a "prediction score" for lack of achievement of ID. RESULTS A total of 375 patients were included in the study. During MTX administration, 8.8% were given systemic corticosteroids and 44.1% intra-articular corticosteroids. After MTX start, 229 (61%) patients achieved ID after a median of 1.7 years, whereas 146 patients (39%) did not reach ID after a median of 1.2 years. On multivariable analysis, independent correlations with lack of achievement of ID were identified for the disease categories of systemic arthritis, enthesitis-related arthritis (ERA) and polyarthritis and C-reactive protein (CRP) > 1.4 mg/dl. The prediction score ranged from 0 to 3 and its cutoff that discriminated best between patients who achieved or did not achieve ID was > 0.5. The categories of systemic arthritis or ERA, both of which had a score greater than 0.5, were sufficient alone to predict a lower likelihood to reach ID. Polyarthritis and increased CRP, whose score was 0.5, assumed a predictive value only when present in association. CONCLUSION A conventional treatment regimen based on MTX as the sole DMARD led to achievement of ID in a sizeable proportion of children with JIA. Our findings help to outline the characteristics of patients who may deserve a synthetic DMARD other than MTX or the introduction of a biologic DMARD from disease outset.
Collapse
|
7
|
Hersh A. Measures of health-related quality of life in pediatric systemic lupus erythematosus: Childhood Health Assessment Questionnaire (C-HAQ), Child Health Questionnaire (CHQ), Pediatric Quality of Life Inventory Generic Core Module (PedsQL-GC), Pediatric Quali. Arthritis Care Res (Hoboken) 2011; 63 Suppl 11:S446-53. [DOI: 10.1002/acr.20559] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
8
|
Angeles-Han ST, Griffin KW, Lehman TJA, Rutledge JR, Lyman S, Nguyen JT, Harrison MJ. The importance of visual function in the quality of life of children with uveitis. J AAPOS 2010; 14:163-8. [PMID: 20236847 PMCID: PMC2866793 DOI: 10.1016/j.jaapos.2009.12.160] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 12/18/2009] [Accepted: 12/22/2009] [Indexed: 11/18/2022]
Abstract
BACKGROUND Studies of quality of life (QOL) in children with juvenile idiopathic arthritis (JIA) have focused on changes in musculoskeletal function secondary to arthritis. The role of visual functionality as a result of JIA-associated uveitis and its complications has not been examined. We evaluated the individual impact of physical and visual disability on QOL in children with and without uveitis. METHODS We administered patient-based questionnaires that measured visual function, physical function, and overall QOL to 27 children with JIA or idiopathic uveitis. Demographic data, assessed joint involvement, and reviewed medical records were recorded. Groups with and without uveitis were compared for differences in arthritis and uveitis disease characteristics with use of the Wilcoxon-Mann-Whitney, chi2, and Fisher exact tests. Associations between physical or visual function, and overall QOL were measured with use of Pearson's correlation coefficient. RESULTS Of 27 patients, 85.2% had had arthritis and 51.9% had had uveitis. The group without uveitis had increased morning stiffness (p = 0.036). Patients with uveitis reported more eye redness (p = 0.033) and photophobia (p = 0.013) than those without uveitis. We observed moderate associations between overall QOL and visual function in the uveitis group (r = -0.579) and overall QOL and physical function in the nonuveitis group (r = -0.562). CONCLUSIONS This study demonstrates that visual impairment is an important component of QOL in children with uveitis. It suggests that QOL studies should incorporate both visual and physical function measures in their analyses, especially because many children with JIA also suffer from uveitis and visual impairment.
Collapse
Affiliation(s)
- Sheila T Angeles-Han
- Emory University, Division of Pediatric Rheumatology, Atlanta, Georgia 30307, USA.
| | | | | | | | | | | | | |
Collapse
|
9
|
Psychosoziale Anpassung bei chronischen Arthritiden. Monatsschr Kinderheilkd 2006. [DOI: 10.1007/s00112-004-1042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Pelaez-Ballestas I, Romero-Mendoza M, Ramos-Lira L, Caballero R, Hernández-Garduño A, Burgos-Vargas R. Illness trajectories in Mexican children with juvenile idiopathic arthritis and their parents. Rheumatology (Oxford) 2006; 45:1399-403. [PMID: 16613916 DOI: 10.1093/rheumatology/kel122] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We hypothesize that the qualitative approach of socio-cultural aspects in children with juvenile idiopathic arthritis (JIA) and their parents would improve the understanding of their illness. OBJECTIVE To explain the phenomenon of experiencing JIA within a specific cultural context. METHODS The theoretical position of this research was based on the substantive theories of suffering, explanatory models and illness experience. Its design was that of qualitative field, and its analysis followed the interpretative grounded theory methodology. Data were collected by in-depth interviews and notes; tape recordings were transcribed verbatim, read and imported into the ATLAS/ti 4.2 software. Data conceptualization, categorization and interpretation were based on the constant comparison method. RESULTS A total of 16 adults and six children from 10 families were interviewed. 'Pilgrimage' (metaphorically referred by some of the parents) was a major code in the study that reflected the religious reference to the trajectory of pain, faith and hope. For children, pilgrimage was conformed by immediate concepts; for parents, by historical and immediate experiences influenced by JIA subtype. Pilgrimage was consistent with the model of the illness trajectory theory, which conceptually relates to the idea that the course of chronic diseases is variable and modifiable throughout time. CONCLUSION The qualitative approach of JIA provides wide and deep information on the perception that children and parents have about the disease. The illness trajectory theory corresponds to pilgrimage, the theoretical model for JIA in this study.
Collapse
|
11
|
Viola S, Felici E, Magni-Manzoni S, Pistorio A, Buoncompagni A, Ruperto N, Rossi F, Bartoli M, Martini A, Ravelli A. Development and validation of a clinical index for assessment of long-term damage in juvenile idiopathic arthritis. ACTA ACUST UNITED AC 2005; 52:2092-102. [PMID: 15986372 DOI: 10.1002/art.21119] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To develop and validate a clinical measure of articular and extraarticular damage in patients with juvenile idiopathic arthritis (JIA). METHODS The Juvenile Arthritis Damage Index (JADI), which is derived from physical examination and a brief review of the patient's clinical history, is composed of 2 parts: assessments of articular damage (JADI-A) and extraarticular damage (JADI-E). Instrument validation was accomplished by evaluating 158 JIA patients with disease duration of at least 5 years, seen consecutively over 21 months. The instrument's feasibility, face and content validity, construct and discriminative ability, internal consistency, and interrater reliability were examined. RESULTS Among the 158 JIA patients, 47% and 37% had articular and extraarticular damage, respectively. The JADI was found to be feasible and to possess both face and content validity. The JADI-A score correlated highly with the number of joints with limited range of motion (Spearman's r [r(S)] = 0.72) and correlated moderately with the Childhood Health Assessment Questionnaire score (r(S) = 0.41), Steinbrocker functional classification (r(S) = 0.50), and Poznanski's score of radiographic damage (r(S) = -0.54), thereby demonstrating good construct validity. Correlations with the JADI-E score were lower, owing to the heterogeneity of its items. The JADI-A discriminated well among different levels of disability. The internal consistency (Chronbach's alpha) of the JADI-A and JADI-E was 0.93 and 0.59, respectively. The intraclass correlation coefficients between pairs of independent observers ranged from 0.85 to 0.97. CONCLUSION The JADI exhibited good reliability, construct validity, and discriminative ability and is therefore a valid instrument for the assessment of long-term damage in patients with JIA, in the context of both clinical management and research settings.
Collapse
|
12
|
Riddle R, Ryser CN, Morton AA, Sampson JD, Browne RH, Punaro MG, Gatchel RJ. The impact on health-related quality of life from non-steroidal anti-inflammatory drugs, methotrexate, or steroids in treatment for juvenile idiopathic arthritis. J Pediatr Psychol 2005; 31:262-71. [PMID: 15872147 DOI: 10.1093/jpepsy/jsj014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess and compare the impact of medication treatments on health-related quality of life (HRQOL), family function, and medical status in children with juvenile idiopathic arthritis (JIA). METHODS Fifty-seven children diagnosed with JIA were assessed by a pediatric rheumatologist and placed into one of three treatment groups: (1) non-steroidal anti-inflammatory; (2) methotrexate; or (3) steroids via IV methylprednisolone. Questionnaires were administered at baseline and 4-month follow-up. The attending pediatric rheumatologist provided additional medical information. RESULTS Data document the impact of JIA on HRQOL, particularly on physical and pain domains. Steroid patients experienced improved HRQOL at follow-up relative to other groups, despite reporting more problems with side effects. CONCLUSION These results demonstrate positive benefits of steroids in treating JIA children, despite the greatest incidence of adverse side effects.
Collapse
Affiliation(s)
- Russ Riddle
- Department of Psychology, Texas Scottish Rite Hospital for Children, 2222 Welborn, Dallas, Texas 75219, USA.
| | | | | | | | | | | | | |
Collapse
|
13
|
Müller-Godeffroy E, Lehmann H, Küster RM, Thyen U. Lebensqualität und psychosoziale Anpassung bei Kindern und Jugendlichen mit juveniler idiopathischer Arthritis und reaktiven Arthritiden. Z Rheumatol 2005; 64:177-87. [PMID: 15868335 DOI: 10.1007/s00393-005-0652-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2003] [Accepted: 08/02/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We sought to measure self-reported health related quality of life (HRQOL) and psychosocial adaptation in children and adolescents with juvenile idiopathic arthritis (JIA) and reactive arthritis and to determine factors associated with these outcomes. METHODS We interviewed 72 children and adolescents with chronic arthritis, age 8-16, about HRQOL (KINDL-R-Questionnaire) and functional ability in activities of daily living (Childhood Health Assessment Questionnaire-CHAQ). Mothers reported behavior problems (Child Behavior Checklist-CBCL). RESULTS Children and adolescents with juvenile idiopathic arthritis and reactive arthritis reported lower HRQOL compared to normative data in several areas. Children reported lower QOL in the dimensions self-esteem; adolescents reported lower QOL in the dimensions physical well being and total QOL. Almost 20% of the sample appeared to have serious behavior problems, mostly social isolation and depression/anxiety. Functional limitations affected HRQOL and behavior problems. Inpatient children and adolescents and those with shorter disease duration reported lower QOL than outpatient children and adolescents and those with longer disease duration. Best predictors for impaired HRQOL were functional limitations, social isolation and depression/anxiety. CONCLUSIONS Self-reported HRQOL and behavior problems may be relevant outcome measures in children and adolescents with chronic arthritis and useful to monitor psychosocial support in this population.
Collapse
Affiliation(s)
- E Müller-Godeffroy
- Universitätsklinikum Lübeck, Klinik für Kinder- und Jugendmedizin, Ratzburger Allee 160, 23538 Lübeck, Germany
| | | | | | | |
Collapse
|
14
|
Zulian F. Outcome measures and medical progress: Why outcome measures are needed in childhood arthritis. Curr Rheumatol Rep 2003; 5:463-70. [PMID: 14609492 DOI: 10.1007/s11926-003-0058-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this review, the historical process leading to the current status of outcome measurements will be discussed and the recent quality-of-life instruments to explore the mental, emotional, and social "hidden morbidity" of children with juvenile arthritis will be analyzed.
Collapse
Affiliation(s)
- Francesco Zulian
- Pediatric Rheumatology Unit, Department of Pediatrics, University of Padua, Via Giustiniani 3, 35128 Padova, Italy.
| |
Collapse
|
15
|
Abstract
PURPOSE OF REVIEW The effects of therapies on the physical function and health-related quality of life of patients are increasingly considered when treatment decisions are made. For the interpretation of the values of the physical function and health-related quality of life measures, their measurement properties have to be studied. RECENT FINDINGS Recent advantages include the determination of the minimal clinically important difference of Child Health Assessment Questionnaire, the cross-cultural adaptation of the Child Health Assessment Questionnaire and the Child Health Questionnaire, as well as the development of the Pediatric Quality of Life Inventory. SUMMARY Despite important advantages in the measurement of physical function and health-related quality of life, additional refinements and validation of the current scales are necessary prior to their use as primary outcome measures for medical treatments.
Collapse
|