Comprehensive Assessment of Quality of Life, Functioning, and Mental Health in Children With Juvenile Idiopathic Arthritis and Noninfectious Uveitis

Abstract

Objective. Pediatric uveitis can lead to sight-threatening complications and can impact quality of life (QoL) and functioning. We aimed to examine health-related QoL, mental health, physical disability, vision-related functioning (VRF), and vision-related QoL in children with juvenile idiopathic arthritis (JIA), JIA-associated uveitis (JIA-U), and other noninfectious uveitis. We hypothesized that there will be differences based on the presence of eye disease.Methods. A multicenter cross-sectional study was conducted at four sites. Patients with JIA, JIA-U, or noninfectious uveitis were enrolled. Patients and parents completed the Pediatric Quality of Life Inventory (PedsQL; healthrelated QoL), the Revised Childhood Anxiety and Depression Scale (RCADS; anxiety/depression), the Childhood Health Assessment Questionnaire (C-HAQ; physical disability), and the Effects of Youngsters' Eyesight on Quality of Life (EYE-Q) (VRF/vision-related QoL). Clinical characteristics and patient-reported outcome measures were compared by diagnosis.Results. Of 549 patients, 332 had JIA, 124 had JIA-U, and 93 had other uveitis diagnoses. Children with JIA-U had worse EYE-Q scores compared to those with JIA only. In children with uveitis, those with anterior uveitis (JIA-U and uveitis only) had less ocular complications, better EYE-Q scores, and worse C-HAQ and PedsQL physical summary scores compared to those with nonanterior disease. In children with anterior uveitis, those with JIA-U had worse PedsQL physical summary and C-HAQ scores than anterior uveitis only. Further, EYE-Q scores were worse in children with bilateral uveitis and more visual impairment. There were no differences in RCADS scores among groups.Conclusion. We provide a comprehensive outcome assessment of children with JIA, JIA-U, and other uveitis diagnoses. Differences in QoL and function were noted based on underlying disease. Our results support the addition of a vision-specific measure to better understand the impact of uveitis.The content herein is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Non-disease specific patient-reported outcome measures of health-related quality of life in juvenile idiopathic arthritis: a systematic review of current research and practice

“…The PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Rheumatology Module have already been used in JIA [ 62 – 64 ], and also in other rheumatic diseases like lupus erythematosus [ 65 ] or fibromyalgia [ 66 ].…”

Economic impact of Juvenile Idiopathic Arthritis: a systematic review

“…Despite this findings, the information collected in our review doesn't allow us to analyze the cost-effectiveness of these therapies on JIA due to the lack of information on IC (including healthrelated quality of life) before and after start of biologics and the relatively short follow-up in most of the studies. These non-monetary costs have been studied in recent years and will need to be included in cost-benefit evaluations in the future [44][45][46].…”

Quantitative and qualitative assessment of anterior segment optical coherence tomography capture of disease state in childhood anterior uveitis

“…Anterior uveitis, the most common manifestation of childhood onset uveitis, 1,2 is often asymptomatic, necessitating regular surveillance examinations for at risk children. 3 Increased anterior chamber cell count is associated with poorer outcomes, 4,5 but the systemic therapy often needed for disease control can be associated with negative impact on quality of life, 6 with consequent impact on family engagement with medical care. There are also challenges around defining disease control and disease remission.…”