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Butler S, Sculley D, Santos D, Girones X, Singh-Grewal D, Coda A. Paediatric Rheumatology Fails to Meet Current Benchmarks, a Call for Health Equity for Children Living with Juvenile Idiopathic Arthritis, Using Digital Health Technologies. Curr Rheumatol Rep 2024; 26:214-221. [PMID: 38466514 PMCID: PMC11116247 DOI: 10.1007/s11926-024-01145-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE OF REVIEW This critical review begins by presenting the history of Juvenile Idiopathic Arthritis (JIA) management. To move the conversation forward in addressing the current shortcomings that exist in the clinical management of children living with JIA, we argue that to date, the advancement of successful treatments for JIA has been historically slow. Factors implicated in this situation include a lack of rigorous research, JIA being considered a rare disease, and JIA's idiopathic and complex pathophysiology. RECENT FINDINGS Despite the well-intended legislative changes to increase paediatric research, and the major advancements seen in molecular medicine over the last 30 years, globally, paediatric rheumatology services are still failing to meet the current benchmarks of best practice. Provoking questions on how the longstanding health care disparities of poor access and delayed treatment for children living with JIA can be improved, to improve healthcare outcomes. Globally, paediatric rheumatology services are failing to meet the current benchmarks of best practice. Raising awareness of the barriers hindering JIA management is the first step in reducing the current health inequalities experienced by children living with JIA. Action must be taken now, to train and well-equip the paediatric rheumatology interdisciplinary workforce. We propose, a resource-efficient way to improve the quality of care provided could be achieved by embedding digital health into clinical practice, to create an integrative care model between the children, general practice and the paediatric rheumatology team. To improve fragmented service delivery and the coordination of interdisciplinary care, across the healthcare system.
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Affiliation(s)
- Sonia Butler
- School of Bioscience and Pharmacy, University of Newcastle, 10 Chittaway Rd, Ourimbah, NSW, 2258, Australia.
| | - Dean Sculley
- School of Bioscience and Pharmacy, University of Newcastle, 10 Chittaway Rd, Ourimbah, NSW, 2258, Australia
| | - Derek Santos
- School of Health Sciences, Queen Margaret University, Musselburgh, EH21 6UU, UK
| | - Xavier Girones
- Faculty of Health Sciences, Universities de Catalunya, Via Laietana, 2. Planta 4, 08003, Barcelona, Spain
| | - Davinder Singh-Grewal
- Department of Rheumatology, Sydney Children's Hospitals Network, Randwick and Westmead, Westmead, NSW, 2145, Australia
- John Hunter Children's Hospital, New Lambton Heights, NSW, 2305, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Camperdown, NSW, 2006, Australia
- School of Women's and Children's Health, University of NSW, Sydney, NSW, 2052, Australia
| | - Andrea Coda
- School of Health Sciences, University of Newcastle, Chittaway Rd, Ourimbah, NSW, 2258, Australia
- 'Equity in Health and Wellbeing Research Program' at the Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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Ngwira LG, Maheswaran H, Verstraete J, Petrou S, Niessen L, Smith SC. Psychometric performance of the Chichewa versions of the EQ-5D-Y-3L and EQ-5D-Y-5L among healthy and sick children and adolescents in Malawi. J Patient Rep Outcomes 2023; 7:22. [PMID: 36892714 PMCID: PMC9996597 DOI: 10.1186/s41687-023-00560-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 02/10/2023] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVES The EuroQol Group has developed an extended version of the EQ-5D-Y-3L with five response levels for each of its five dimensions (EQ-5D-Y-5L). The psychometric performance has been reported in several studies for the EQ-5D-Y-3L but not for the EQ-5D-Y-5L. This study aimed to psychometrically evaluate the EQ-5D-Y-3L and EQ-5D-Y-5L Chichewa (Malawi) versions. METHODS The EQ-5D-Y-3L, EQ-5D-Y-5L and PedsQL™ 4.0 Chichewa versions were administered to children and adolescents aged 8-17 years in Blantyre, Malawi. Both of the EQ-5D-Y versions were evaluated for missing data, floor/ceiling effects, and validity (convergent, discriminant, known-group and empirical). RESULTS A total of 289 participants (95 healthy, and 194 chronic and acute) self-completed the questionnaires. There was little problem with missing data (< 5%) except in children aged 8-12 years particularly for the EQ-5D-Y-5L. Ceiling effects was generally reduced in moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. For both EQ-5D-Y-3L and EQ-5D-Y-5L, convergent validity tested with PedsQL™ 4.0 was found to be satisfactory (correlation ≥ 0.4) at scale level but mixed at dimension /sub-scale level. There was evidence of discriminant validity (p > 0.05) with respect to gender and age, but not for school grade (p < 0.05). For empirical validity, the EQ-5D-Y-5L was 31-91% less efficient than the EQ-5D-Y-3L at detecting differences in health status using external measures. CONCLUSIONS Both versions of the EQ-5D-Y-3L and EQ-5D-Y-5L had issues with missing data in younger children. Convergent validity, discriminant validity with respect to gender and age, and known-group validity of either measures were also met for use among children and adolescents in this population, although with some limitations (discriminant validity by grade and empirical validity). The EQ-5D-Y-3L seems particularly suited for use in younger children (8-12 years) and the EQ-5D-Y-5L in adolescents (13-17 years). However, further psychometric testing is required for test re-test reliability and responsiveness that could not be carried out in this study due to COVID-19 restrictions.
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Affiliation(s)
- Lucky G Ngwira
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chipatala Avenue, P.O. Box 30096, Chichiri, Blantyre 3, Malawi. .,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
| | | | | | | | - Louis Niessen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.,John Hopkins School of Public Health, Baltimore, MD, USA
| | - Sarah C Smith
- London School of Hygiene and Tropical Medicine, London, UK
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Grazziotin LR, Currie G, Twilt M, IJzerman MJ, Kip MMA, Koffijberg H, Bonsel G, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Armbrust W, van den Berg JM, Marshall DA. Factors associated with care- and health-related quality of life of caregivers of children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2022; 20:51. [PMID: 35870932 PMCID: PMC9308305 DOI: 10.1186/s12969-022-00713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigates the relationship of child, caregiver, and caring context measurements with the care-related quality of life (CRQoL) and health-related quality of life (HRQoL) of caregivers of children with juvenile idiopathic arthritis (JIA). METHODS We performed a cross-sectional analysis of baseline data on caregivers of children with JIA from Canada and the Netherlands collected for the "Canada-Netherlands Personalized Medicine Network in Childhood Arthritis and Rheumatic Diseases" study from June 2019 to September 2021. We used the CRQoL questionnaire (CarerQoL), adult EQ-5D-5L, and proxy-reported Youth 5-Level version of EuroQoL (EQ-5D-5L-Y) to assess caregiver CRQoL, caregiver HRQoL, and child HRQoL, respectively. We used a multivariate analysis to assess the relationship between both caregiver CRQoL and HRQoL and patient, caregiver, and caring context measurements. RESULTS A total of 250 caregivers were included in this study. Most of the caregivers were from the Netherlands (n = 178, 71%) and 77% were females (n = 193). The mean CarerQoL scores was 82.7 (standard deviation (SD) 11.4) and the mean EQ-5D-5L utility score was 0.87 (SD 0.16). Child HRQoL and employment had a positive relationship with both caregiver CarerQoL and EQ-5D-5L utility scores (p < 0.05), while receiving paid or unpaid help had a negative relationship with both scores (p < 0.05). CONCLUSION Our findings indicated that to understand the impact of JIA on families, we need to consider socio-economic factors, such as employment and support to carry caregiving tasks, in addition to child HRQoL.
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Affiliation(s)
- Luiza R. Grazziotin
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697McCaig Institute for Bone and Joint Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697O’Brien Institute for Public Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Gillian Currie
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697O’Brien Institute for Public Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Marinka Twilt
- grid.22072.350000 0004 1936 7697McCaig Institute for Bone and Joint Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Section of Rheumatology, Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Maarten J. IJzerman
- grid.6214.10000 0004 0399 8953Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Michelle M. A. Kip
- grid.6214.10000 0004 0399 8953Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Hendrik Koffijberg
- grid.6214.10000 0004 0399 8953Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Gouke Bonsel
- grid.478988.20000 0004 5906 3508EuroQol Research Foundation, Rotterdam, the Netherlands
| | - Susanne M. Benseler
- grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Section of Rheumatology, Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada ,grid.413574.00000 0001 0693 8815Alberta Health Services, Calgary, Alberta Canada
| | - Joost F. Swart
- grid.417100.30000 0004 0620 3132Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital / UMC Utrecht, Utrecht, Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Sebastiaan J. Vastert
- grid.417100.30000 0004 0620 3132Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital / UMC Utrecht, Utrecht, Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Nico M. Wulffraat
- grid.417100.30000 0004 0620 3132Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital / UMC Utrecht, Utrecht, Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Rae S. M. Yeung
- grid.17063.330000 0001 2157 2938Departments of Paediatrics, Immunology and Medical Science, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Wineke Armbrust
- grid.4494.d0000 0000 9558 4598Wineke Armbrust University of Groningen, University Medical Center Groningen (UMCG), Beatrix Childrens Hospital, Dept Pediatric Rheumatology-Immunology, Groningen, Netherlands
| | - J. Merlijn van den Berg
- grid.7177.60000000084992262Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children’s Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, Netherlands
| | - Deborah A. Marshall
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697McCaig Institute for Bone and Joint Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697O’Brien Institute for Public Health, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Alberta Children’s Hospital Research Institute, University of Calgary, Room 3C56, Health Research Innovation Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
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Golicki D, Młyńczak K. Measurement Properties of the EQ-5D-Y: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:S1098-3015(22)02001-0. [PMID: 35752534 DOI: 10.1016/j.jval.2022.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/16/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to perform a systematic review of published evidence on the psychometric properties of 3-level version of EQ-5D-Y and 5-level version of EQ-5D-Y (EQ-5D-Y-5L). METHODS A literature search on the MEDLINE, Embase, and EuroQol website (until June 2021) was conducted. Original studies on EQ-5D-Y psychometric properties such as feasibility, distribution properties (ceiling and floor effects), reliability (test-retest, interrater, intermodal), validity (known-groups, convergent), and responsiveness, published as full-text articles in English, were included. Studies on experimental EQ-5D-Y versions were excluded. The following data were pooled using random effects models: missing values, the ceiling effect, and correlations coefficients with other measures. RESULTS A total of 47 studies (inclusive of 7 on EQ-5D-Y-5L) containing data from 45 310 children and 2690 proxy respondents representing 15 countries were included. These studies were characterized as being high quality according to the quality index. The most represented areas were school populations and musculoskeletal diseases and orthopedics. The EQ-5D-Y dimensions, EQ visual analog scale, and EQ index were reported in 89%, 77%, and 26% of studies, respectively. Most articles addressed validity (known-groups, n = 27; convergent, n = 21) and reliability (test-retest and interrater, n = 10 each). Convergent validity studies showed that, where the assessment of the child's functioning at school is required, EQ-5D-Y should be supplemented with other school-specific measures. CONCLUSIONS This systematic review provides a summary of measurement properties and the psychometric performance of 3-level version of EQ-5D-Y and EQ-5D-Y-5L. The existing evidence supports using the EQ-5D-Y descriptive system and EQ visual analog scale in children and adolescent populations. Further research on test-retest reliability and the responsiveness of the EQ-5D-Y index obtained with child-specific value sets is needed.
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Affiliation(s)
- Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
| | - Katarzyna Młyńczak
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
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5
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Butler S, Sculley D, Santos D, Fellas A, Gironès X, Singh-Grewal D, Coda A. Effectiveness of eHealth and mHealth Interventions Supporting Children and Young People Living With Juvenile Idiopathic Arthritis: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e30457. [PMID: 35107431 PMCID: PMC8851322 DOI: 10.2196/30457] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/10/2021] [Accepted: 11/08/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) management aims to promote remission through timely, individualized, well-coordinated interdisciplinary care using a range of pharmacological, physical, psychological, and educational interventions. However, achieving this goal is workforce-intensive. Harnessing the burgeoning eHealth and mobile health (mHealth) interventions could be a resource-efficient way of supplementing JIA management. OBJECTIVE This systematic review aims to identify the eHealth and mHealth interventions that have been proven to be effective in supporting health outcomes for children and young people (aged 1-18 years) living with JIA. METHODS We systematically searched 15 databases (2018-2021). Studies were eligible if they considered children and young people (aged 1-18 years) diagnosed with JIA, an eHealth or mHealth intervention, any comparator, and health outcomes related to the used interventions. Independently, 2 reviewers screened the studies for inclusion and appraised the study quality using the Downs and Black (modified) checklist. Study outcomes were summarized using a narrative, descriptive method and, where possible, combined for a meta-analysis using a random-effects model. RESULTS Of the 301 studies identified in the search strategy, 15 (5%) fair-to-good-quality studies met the inclusion criteria, which identified 10 interventions for JIA (age 4-18.6 years). Of these 10 interventions, 5 (50%) supported symptom monitoring by capturing real-time data using health applications, electronic diaries, or web-based portals to monitor pain or health-related quality of life (HRQoL). Within individual studies, a preference was demonstrated for real-time pain monitoring over recall pain assessments because of a peak-end effect, improved time efficiency (P=.002), and meeting children's and young people's HRQoL needs (P<.001) during pediatric rheumatology consultations. Furthermore, 20% (2/10) of interventions supported physical activity promotion using a web-based program or a wearable activity tracker. The web-based program exhibited a moderate effect, which increased endurance time, physical activity levels, and moderate to vigorous physical activity (standardized mean difference [SMD] 0.60, SD 0.02-1.18; I2=79%; P=.04). The final 30% (3/10) of interventions supported self-management development through web-based programs, or apps, facilitating a small effect, reducing pain intensity (SMD -0.14, 95% CI -0.43 to 0.15; I2=53%; P=.33), and increasing disease knowledge and self-efficacy (SMD 0.30, 95% CI 0.03-0.56; I2=74%; P=.03). These results were not statistically significant. No effect was seen regarding pain interference, HRQoL, anxiety, depression, pain coping, disease activity, functional ability, or treatment adherence. CONCLUSIONS Evidence that supports the inclusion of eHealth and mHealth interventions in JIA management is increasing. However, this evidence needs to be considered cautiously because of the small sample size, wide CIs, and moderate to high statistical heterogeneity. More rigorous research is needed on the longitudinal effects of real-time monitoring, web-based pediatric rheumatologist-children and young people interactions, the comparison among different self-management programs, and the use of wearable technologies as an objective measurement for monitoring physical activity before any recommendations that inform current practice can be given.
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Affiliation(s)
- Sonia Butler
- School of Bioscience and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, Australia
| | - Dean Sculley
- School of Bioscience and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, Australia
| | - Derek Santos
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Antoni Fellas
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Xavier Gironès
- University of Vic-Central University of Catalonia, Manresa, Spain
| | - Davinder Singh-Grewal
- Department of Rheumatology, Sydney Children's Hospitals Network, Randwick and Westmead, Sydney, Australia.,Department of Rheumatology, John Hunter Children's Hospital, Newcastle, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
| | - Andrea Coda
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Priority Research Centre Health Behaviour, Hunter Medical Research Institute, Newcastle, Australia
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Młyńczyk J, Abramowicz P, Stawicki MK, Konstantynowicz J. Non-disease specific patient-reported outcome measures of health-related quality of life in juvenile idiopathic arthritis: a systematic review of current research and practice. Rheumatol Int 2021; 42:191-203. [PMID: 34971434 PMCID: PMC8719533 DOI: 10.1007/s00296-021-05077-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with symptoms negatively impacting health-related quality of life (HRQL). Regarding growing interest in the implementation of the patient-reported outcome measures (PROMs), we aimed to review the non-disease specific PROMs addressing HRQL assessment, potentially useful in the clinical care of JIA and daily practice. A systematic literature search was conducted using MEDLINE/PubMed, Google Scholar, Scopus and Embase databases (1990 to 2021), with a focus on the recent 5-years period. Entry keywords included the terms: “children”, “adolescents”, “JIA”, “chronic diseases”, “HRQL”, “PROMs” and wordings for the specific tools. Several available PROMs intended to measure HRQL, non-specific to JIA, were identified. The presented outcomes differed in psychometric properties, yet all were feasible in assessing HRQL in healthy children and those with chronic diseases. Both EQ-5D-Y and PedsQL have already been tested in JIA, showing relevant reliability, validity, and similar efficiency as disease-specific measurements. For PROMIS® PGH-7 and PGH-7 + 2, such validation and cross-cultural adaptation need to be performed. Considering the future directions in pediatric rheumatology, the large-scale implementation of PROMIS® PGH-7 and PGH-7 + 2 in JIA offers a particularly valuable opportunity. The PROMs reflect the patient perception of the chronic disease and allow to understand child’s opinions. The PROMs may provide an important element of the holistic medical care of patients with JIA and a standardized tool for clinical outcomes, monitoring disease severity and response to treatment.
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Affiliation(s)
- Justyna Młyńczyk
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland
| | - Paweł Abramowicz
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland
| | - Maciej K Stawicki
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland.
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