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Abstract Number: 2404

Quality of Life Assessment in Juvenile Idiopathic Arthritis: A Single Center Assessment

W. Blaine Lapin1, Taylor Phillips2, Danielle Guttman-Lapin3, Amanda Brown4, Eyal Muscal5 and Filiz O. Seeborg1, 1Department of Pediatrics, Division of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, 2Rice University, Houston, TX, 3Aldine Independent School District, Aldine, TX, 4Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, Baylor College of Medicine, houston, TX, 5Department of Pediatrics, Division of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: juvenile idiopathic arthritis (JIA), Pediatric rheumatology, psychosocial factors and quality of life

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Session Information

Date: Tuesday, October 23, 2018

Title: Pediatric Rheumatology – Clinical Poster III: Juvenile Idiopathic Arthritis and Uveitis

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Patients with Juvenile Idiopathic Arthritis (JIA) face physical, social, and emotional issues that affect their quality of life. Health-related quality of life (HRQoL) is a multidimensional construct including those issues and other influences of illness on well-being. Previous validation studies found that JIA patients have lower HRQoL compared to healthy peers. We investigated perceptions of HRQoL based on assessments completed by children and their caregivers at a large referral center. We obtained HRQoL data as an initial phase of a larger project striving to educate school nurses and staff at a large urban school district.

Methods:

We assessed HRQoL with the PedsQL 4.0 Generic Core Scale (assesses physical activity, emotional, social, and school functioning) and the PedsQL 3.0 Arthritis Module (measures pediatric rheumatology-specific HRQoL: pain and hurt, daily activities, treatment, worry, and communication). Both surveys have age-specific, validated forms (Ages 5-7, 8-12, and 13-18). After IRB approval, we enrolled a 3-month convenience sample of English speaking JIA patients ages 5 to 18, and caregivers who presented to an outpatient clinic. For each survey we calculated subscale and total score means. Higher scores indicated a better HRQoL. We used descriptive and inferential statistics (Pearson correlation, one-way ANOVA and one sample t-tests) to explore HRQoL data in JIA patients. Results were compared to validated healthy control normative values.

Results:

Seventy-nine JIA patients and caregivers completed the surveys. Demographic data included patient age (mean 12.05 ± 3.73), gender (female 68%), ethnicity (49% White or Non-Hispanic, 25% Hispanic). Patient JIA classification included: Polyarticular 46.8%, Oligoarticular 30.4%, Psoriatic 8.9%, Systemic 7.6%, and Enthesitis-related 6.3%. The cohort mean total score (72.27) was significantly lower than the previously validated total score for of 83.9 for heathy children (95% CI -15.6 to -7.6; p< .001). There were modest, mostly negative and at times significant correlations between age and HRQoL domain scores (Table 1). Statistically significant differences in Physical health, Total score (PedsQL 4.0), Daily Activities and Worry (PedsQL 3.0) were driven by lower scores of children with Polyarticular JIA. These differences appeared independent of age and gender.

Table 1: Child PedsQL 4.0 Generic and PedsQL 3.0 Arthritis Module Domain Scores

Mean (SD)

Correlation with Age

Significance (2-tailed)

Peds QL 4.0-Generic

Physical

72.60 (20.19)

-.386**

<.01

Emotional

73.45 (22.45)

-.209

NS

Social

77.41 (22.50)

-.043

NS

School

64.99 (23.43)

-.221

.05

Psychosocial

71.95 (19.87)

-.182

NS

Total

72.27(17.90)

-.318**

<.01

Peds QL 3.0-Arthritis

Pain and Hurt

64.82 (27.13)

-.234*

.04

Daily Activities

90.40 (14.98)

-.111

NS

Treatment

70.19 (20.55)

.246*

.03

Worry

67.30 (29.50)

.268*

.02

Communication

68.67 (24.83)

-.137

NS

Bolded values are below total mean score

* Correlation is significant at the 0.05 level (2-tailed).

** Correlation is significant at the 0.01 level (2-tailed).

NS: Not significant

Conclusion:

As per previous studies, PedsQL scores in JIA patients were significantly lower than healthy norms. These differences may be accentuated in older children and polyarticular subtypes. Disease activity factors will be assessed at the completion of cohort data collection. We will use PedsQL data to train public school nurses about the impact of JIA on HRQoL. QoL interventions may depend on age groups, and may constitute an additional parameter in the management of children with rheumatic diseases.


Disclosure: W. B. Lapin, None; T. Phillips, None; D. Guttman-Lapin, None; A. Brown, None; E. Muscal, None; F. O. Seeborg, None.

To cite this abstract in AMA style:

Lapin WB, Phillips T, Guttman-Lapin D, Brown A, Muscal E, Seeborg FO. Quality of Life Assessment in Juvenile Idiopathic Arthritis: A Single Center Assessment [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/quality-of-life-assessment-in-juvenile-idiopathic-arthritis-a-single-center-assessment/. Accessed .
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