Patient-reported Outcomes across Categories of Juvenile Idiopathic Arthritis

J Rheumatol. 2015 Oct;42(10):1914-21. doi: 10.3899/jrheum.150092. Epub 2015 Sep 1.

Abstract

Objective: Although there is increasing reliance on patient-reported outcomes (PRO) for disease management, there is little known about the differences in PRO across juvenile idiopathic arthritis (JIA) categories. The purpose of our study was to assess PRO across JIA categories, including pain, quality of life, and physical function, and to determine clinical factors associated with differences in these measures across categories.

Methods: This was a longitudinal cohort study of patients with JIA at a tertiary care pediatric rheumatology clinic. Subjects, PRO, and clinical variables were identified by querying the electronic medical record. Mixed-effects regression assessed pain, quality of life, and function.

Results: Subjects with enthesitis-related arthritis (ERA) and undifferentiated JIA had significantly more pain, poorer quality of life, and poorer physical function. The ERA and undifferentiated JIA categories, physician's global disease activity assessment, female sex, and nonsteroidal antiinflammatory drug use were significantly associated with more pain, poorer quality of life, and poorer function. In models limited to ERA, female sex and tender enthesis count were significant predictors of decreased function.

Conclusion: ERA and undifferentiated JIA categories had poorer PRO than other JIA categories. Further work is needed to address ways to improve PRO in children with JIA, with a special focus on children with ERA and undifferentiated JIA.

Keywords: JUVENILE ARTHRITIS; PAIN; PATIENT OUTCOME ASSESSMENT; PEDIATRIC; QUALITY OF LIFE; RHEUMATOLOGY.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Juvenile / diagnosis
  • Arthritis, Juvenile / drug therapy*
  • Arthritis, Juvenile / psychology
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Chronic Pain / drug therapy
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Hospitals, Pediatric
  • Humans
  • Longitudinal Studies
  • Male
  • Pain Measurement
  • Patient Outcome Assessment*
  • Philadelphia
  • Quality of Life*
  • Retrospective Studies
  • Risk Assessment
  • Self Report*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antirheumatic Agents