Health-Related Quality of Life in an Inception Cohort of Children With Juvenile Idiopathic Arthritis: A Longitudinal Analysis.

Autor: Oen K; University of Manitoba, Winnipeg, Manitoba, Canada., Guzman J; British Columbia's Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Dufault B; University of Manitoba, Winnipeg, Manitoba, Canada., Tucker LB; British Columbia's Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Shiff NJ; University of Florida, Gainesville, Florida, and University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Duffy KW; Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada., Lee JJY; University of Ottawa, Ottawa, Ontario, Canada., Feldman BM; Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada., Berard RA; Children's Hospital, London Health Sciences Centre, and Western University, London, Ontario, Canada., Dancey P; Memorial University, St. John's, Newfoundland and Labrador, Canada., Huber AM; IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada., Scuccimarri R; McGill University, Montreal, Quebec, Canada., Cabral DA; British Columbia's Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Morishita KA; British Columbia's Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Ramsey SE; IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada., Rosenberg AM; University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Boire G; Université de Sherbrooke, Sherbrooke, Quebec, Canada., Benseler SM; Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada., Lang B; IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada., Houghton K; British Columbia's Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Miettunen PM; Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada., Chédeville G; McGill University, Montreal, Quebec, Canada., Levy DM; Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada., Bruns A; Université de Sherbrooke, Sherbrooke, Quebec, Canada., Schmeling H; Alberta Children's Hospital and University of Calgary, Calgary, Alberta, Canada., Haddad E; CHU Ste. Justine and Université de Montréal, Montreal, Quebec, Canada., Yeung RSM; Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada., Duffy CM; Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2018 Jan; Vol. 70 (1), pp. 134-144. Date of Electronic Publication: 2017 Dec 06.
DOI: 10.1002/acr.23236
Abstrakt: Objective: To describe changes in health-related quality of life (HRQoL) over time in children with juvenile idiopathic arthritis (JIA), relative to other outcomes, and to identify predictors of unfavorable HRQoL trajectories.
Methods: Children with JIA in the Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) cohort were included. The Juvenile Arthritis Quality of Life Questionnaire (JAQQ, a standardized instrument), health-related Quality of My Life (HRQoML, an instrument based on personal valuations), and JIA core variables were completed serially. Analyses included median values, Kaplan-Meier survival curves, and latent trajectory analysis.
Results: A total of 1,249 patients enrolled at a median of 0.5 months after diagnosis were followed for a median of 34.2 months. The degree of initial HRQoL impairment and probabilities of reaching the best possible HRQoL scores varied across JIA categories (best for oligoarthritis, worst for rheumatoid factor-positive polyarthritis). Median times to attain best possible HRQoL scores (JAQQ 59.3 months, HRQoML 34.5 months), lagged behind those for disease activity, pain, and disability measures. Most patients followed trajectories with minimal or mild impairment; however, 7.6% and 13.8% of patients, respectively, followed JAQQ and HRQoML trajectories with persistent major impairment in HRQoL. JIA category, aboriginal ethnicity, and baseline disease activity measures distinguished between membership in trajectories with major and minimal impairments.
Conclusion: Improvement in HRQoL is slower than for disease activity, pain, and disability. Improvement of a measure based on respondents' preferences (HRQoML) is more rapid than that of a standardized measure (JAQQ). Higher disease activity at diagnosis heralds an unfavorable HRQoL trajectory.
(© 2017, American College of Rheumatology.)
Databáze: MEDLINE
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