Title

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

Authors

Kiem Oen, University of Manitoba
Jaime Guzman, British Columbia's Children's Hospital and University of British Columbia
Brenden Dufault, University of Manitoba
Lori B Tucker, British Columbia's Children's Hospital and University of British Columbia
Natalie J Shiff, University of Saskatchewan
Karen Watanabe Duffy, University of Ottawa
Jennifer J Y Lee, University of Ottawa
Brian M Feldman, University of Toronto
Roberta A Berard, Western University
Paul Dancey, Memorial University
Adam M Huber, Dalhousie University
Rosie Scuccimarri, McGill University
David A Cabral, University of British Columbia
Kimberly A Morishita, University of British Columbia
Suzanne E Ramsey, Dalhousie University
Alan M Rosenberg, University of Saskatchewan
Gilles Boire, Université de Sherbrooke
Susanne M Benseler, University of Calgary
Bianca Lang, Dalhousie University
Kristin Houghton, University of British Columbia
Paivi M Miettunen, University of Calgary
Gaëlle Chédeville, McGill University
Deborah M Levy, University of Toronto
Alessandra Bruns, Université de Sherbrooke
Heinrike Schmeling, University of Calgary
Elie Haddad, Université de Montréal
Rae S M Yeung, University of Toronto
Ciarán M Duffy, University of Ottawa
The Research in Arthritis in Canadian Children emphasizing Outcomes (ReACCh-Out) investigators

Document Type

Article

Publication Date

1-2018

Journal

Arthritis Care Res

Volume

70

Issue

1

First Page

134

Last Page

144

URL with Digital Object Identifier

https://doi.org/10.1002/acr.23236

Abstract

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.