Session Information
Date: Monday, November 9, 2015
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose : A
number of validated measures are now available for the evaluation of health
related quality of life (HRQOL) in children with rheumatic diseases, but most
are lengthy and not feasible for use in a clinical setting.
The objective of this study
was to document the degree of HRQOL impairment in juvenile idiopathic arthritis
(JIA) and juvenile-onset fibromyalgia (JFM) patients using the SF-10v2®
questionnaire.
Methods : Patients
ages 5-18 years with a diagnosis of JIA or JFM were recruited during routine
clinic visits in Cincinnati Children’s Hospital Medical Center (CCHMC) over 6
months. Demographic data as well as disease severity scores, including the physician’s
global, parental overall wellbeing and pain scores, were recorded from the
patients’ medical records. HRQOL was ascertained via the SF-10v2®
Health Survey questionnaire. The SF-10v2® is a 10-item caregiver-completed,
generic measure of children’s functional health and wellbeing over the
preceding 4 weeks; the SF10v2® features 2 summary measures – the
physical summary score [PHS] and the psychosocial summary score [PSS].
This was an exploratory,
cross-sectional descriptive study that examined the variation in HRQOL scores in
relation to different patient and disease characteristics, and compared the
scores of JIA and JFM patients to U.S age-and-gender-matched healthy and
physically ill children.
Results : 133
JIA and 9 JFM patients were included in the analysis. For JIA patients, mean
age at study entry and the mean duration of disease were 11.5 and 4.1 years,
respectively; 63% were female and 90% were Caucasian. All JFM patients were
Caucasian females with a mean age and mean duration of disease of 12.2 and 1
years, respectively.
Both summary scores of the SF-10v2®
were lower among JFM patients compared to JIA patients and to the age-and-gender-matched
healthy and physically ill populations. In contrast, the PHS only was lower for
JIA patients compared with the healthy and physically ill populations (Table 1).
Among the different JIA categories,
PHS scores for enthesitis-related arthritis (ERA) patients were lower than those
for polyarticular RF (-) JIA patients (31.72 vs. 45.31 p=0.018). For the JIA patients,
PHS scores were lower with active disease, abnormal parental scores and reported
pain. Age, gender, race, disease duration and additional autoimmune disease
were not associated with reduced scores (Table 2).
Conclusion :
HRQOL was lower among JIA and JFM patients compared to healthy and physically
ill children. Active disease and reported pain were the most important
predictors of reduced HRQOL among JIA patients.
|
Table 1: One-way ANOVA of HRQOL summary scores of JIA and JFM patients relative to age-and-gender-matched healthy and other physically ill U.S. children |
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|
|
Healthy* |
Physically ill* |
JIA |
JFM |
|
|
Tukey’s post-hoc analyses |
||||
|
|
N |
Mean (SD) |
N |
Mean (SD) |
N |
Mean (SD) |
N |
Mean (SD) |
F |
P |
|
|
PHS |
1255 |
53.88 (5.2) |
836 |
48.17 (11) |
133 |
41.93 (14.83) |
9 |
13.77 (11.84) |
182 |
0.00 |
All comparisons were significant |
|
PSS |
54.61 (5.87) |
53.1 (6.61) |
53.61 (8.97) |
42.77 (11.93) |
18.61 |
0.00 |
Well vs. ill; Well vs. JFM; Physically ill vs. JFM; JIA vs. JFM – P=0.00 Well vs. JIA and Physically ill vs. JIA – NS** |
||||
|
* The comparison populations were taken from a 2006 US general population sample with and without a parent-reported chronic condition, as provided by QualityMetric Inc. **NS – non-significant |
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|
Table 2: Comparisons of PHS and PSS in relation to different patient and disease characteristics among JIA patients |
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|
Variable |
|
N |
Physical summary score (PHS) |
Psychosocial summary score (PSS) |
||||
|
|
|
|
Mean (SD) |
T-score |
p-value |
Mean (SD) |
T-score |
p-value |
|
Age
|
Age ≤ median |
66 |
43.14 (15.24) |
0.933 |
0.352 |
54.15 (8.83) |
0.581 |
0.561 |
|
Age > median |
67 |
40.74 (14.42) |
53.24 (9.2) |
|||||
|
Race |
Caucasian |
121 |
41.54 (15) |
0.97 |
0.333 |
53.86 (9) |
0.7 |
0.489 |
|
Non-Caucasian |
12 |
45.87 (11.62) |
51.95 (8.9) |
|||||
|
Gender |
Female |
84 |
43.56 (14.44) |
1.665 |
0.0982 |
53.77 (9.44) |
0.129 |
0.897 |
|
Male |
49 |
39.15 (15.22) |
53.56 (8.28) |
|||||
|
Duration of disease |
Duration ≤ median |
70 |
39.74 (15.5) |
1.80 |
0.072 |
53.81 (8.4) |
0.159 |
0.873 |
|
Duration > median |
63 |
44.36 (13.69) |
53.56 (9.67) |
|||||
|
Autoimmune disease |
Yes |
27 |
43.47 (15.08) |
0.6 |
0.548 |
46.24 (16.59) |
0.77 |
0.439 |
|
No |
106 |
41.54 (14.81) |
50.31 (10.66) |
|||||
|
Physician global score |
<0.5 |
66 |
46.6 (12.02) |
3.84 |
0.0002 |
53.36 (9.43) |
0.16 |
0.872 |
|
≥0.5 |
57 |
36.9 (15.9) |
53.63 (9.04) |
|||||
|
Parental score |
0 |
56 |
52.52 (5.15) |
9.03 |
<0.0001 |
55.18 (6.07) |
1.567 |
0.119 |
|
>0 |
68 |
33.68 (14.88) |
52.68 (10.58) |
|||||
|
Pain report |
No pain |
45 |
52.74 (5.45) |
6.94 |
<0.0001 |
54.02 (6.94) |
0.22 |
0.895 |
|
>0 |
86 |
36.45 (15.2) |
53.66 (9.73) |
|||||
To cite this abstract in AMA style:
Feldon M, Donnelly C, Brunner HI, Johnson AL, Itert L, Rider LG, Giannini EH. Health Related Quality of Life Is Reduced in Pediatric Patients with Juvenile Idiopathic Arthritis and Juvenile-Onset Fibromyalgia [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/health-related-quality-of-life-is-reduced-in-pediatric-patients-with-juvenile-idiopathic-arthritis-and-juvenile-onset-fibromyalgia/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/health-related-quality-of-life-is-reduced-in-pediatric-patients-with-juvenile-idiopathic-arthritis-and-juvenile-onset-fibromyalgia/