Session Type: ACR Concurrent Abstract Session
Session Time: 11:00AM-12:30PM
Background/Purpose: Juvenile Idiopathic Arthritis (JIA) is a common chronic childhood illness associated with negative impact on health-related quality of life (HRQL). As teens mature, they are expected to assume greater responsibility in disease management. There is evidence to suggest that psycho-educational treatments can improve health outcomes in teens with JIA. However, the vast majority do not receive comprehensive self-management education. An Internet-based intervention was developed to help improve accessibility and disease self-management for teens with JIA. This intervention consisted of disease education, self-management strategies, and social support. A randomized controlled trial design was used to determine the effectiveness of the intervention.
Methods: Participants were between 12-18 years old with JIA across 11 pediatric centers in Canada. Most teens participated with a parent/caregiver. Intervention participants reviewed 12 modules focused on disease education and self-management strategies. Control participants reviewed standard disease education modules without self-management material. Over the 3-month program, health coaches had monthly check-ins with teens, but only reviewed modules with intervention participants. Parents in both groups reviewed modules on promoting independence and disease self-management in their teen. Participants completed outcome measures at 4 time points: baseline, program completion, 3-months, and 6-months after the program. Primary outcomes were: pain and HRQL. Secondary outcomes were: emotional symptoms, adherence, coping, knowledge, and self-efficacy.
Results: In total, 333 teens (n = 109 male, n = 224 female; mean age = 14.5, SD = 1.7) and 306 parents (n = 52 male, n = 254 female) were enrolled. Of the 164 intervention participants, 62.8% (n = 103) completed the study over an average 189.8 days (SD=113.5). Of the 169 control participants, 87.0% (n = 147) completed the study over 123.6 days (SD=70.6). Analyses indicate a significant overall reduction in pain interference in enjoying daily life for intervention participants compared to control after adjusting for baseline level of interference (intervention: M=1.03, SE=0.16; control: M=1.62, SE=0.13; p=0.004). There was also a significant difference interaction between intervention group and time (p=0.001) for HRQL related to treatment problems. Specifically, the intervention group reported improved HRQL versus control participants by 12 months (Mean difference at 12 months=3.22, SE=1.56, adjusted p=0.040). Participants in both groups showed non-significant improvements over time, compared to baseline, in pain coping, self-efficacy, disease knowledge, and HRQL. The majority of teens in the intervention found the coach calls helpful and were satisfied with call frequency. Most teens also found the website text content, videos, graphics/animations, and relaxation exercises helpful.
Conclusion: Teens and parents enjoyed being part of the study and the program improved aspects of HRQL. Education and social support factors may be key determinants of improving patient reported outcomes. The intervention website has been launched to the general public (URL: teens.aboutkidshealth.ca/jia).
To cite this abstract in AMA style:Stinson JN, Campillo S, Cellucci T, Dancey P, Duffy CM, Ellsworth J, Feldman BM, Huber A, Johnson N, McGrath P, Rosenberg A, Shiff NJ, Spiegel LR, Tse SML, Tucker L, Victor JC, Luca S. A Randomized Controlled Trial (RCT) of an Internet-Based Self-Management Program for Adolescents with Juvenile Idiopathic Arthritis (JIA) [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/a-randomized-controlled-trial-rct-of-an-internet-based-self-management-program-for-adolescents-with-juvenile-idiopathic-arthritis-jia/. Accessed August 23, 2019.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-randomized-controlled-trial-rct-of-an-internet-based-self-management-program-for-adolescents-with-juvenile-idiopathic-arthritis-jia/