Title

Health-Related Quality of Life Over Time in Children With Eosinophilic Esophagitis and Their Families

Authors

Authors

M. D. Klinnert; L. Silveira; R. Harris; W. Moore; D. Atkins; D. M. Fleischer; C. Menard-Katcher; S. Aceves; J. M. Spergel; J. P. Franciosi;G. T. Furuta

Comments

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Abbreviated Journal Title

J. Pediatr. Gastroenterol. Nutr.

Keywords

eosinophilic esophagitis; family impact; health-related quality of life; pediatric; GENERIC CORE SCALES; ELIMINATION DIET; GASTROINTESTINAL DISORDERS; CONSENSUS RECOMMENDATIONS; FLUTICASONE PROPIONATE; PARENTING STRESS; IMPACT MODULE; RELIABILITY; VALIDITY; PEDSQL(TM)-4.0; Gastroenterology & Hepatology; Nutrition & Dietetics; Pediatrics

Abstract

Objectives: Existing treatments for pediatric eosinophilic esophagitis (EoE) effectively reduce inflammation. The impact of treatment on health-related quality of life (HRQoL) over time for pediatric patients with EoE and their families, however, has not been systematically assessed. We hypothesized that individualized multidisciplinary treatment would improve both child and family HRQoL over time, with improvements associated with decreased symptom severity. Methods: Children with EoE treated in 4 tertiary care centers were enrolled. Baseline assessments occurred at the time of patients' first evaluation; follow-up assessments occurred at 2 and 6 months after baseline. Presence and severity of 8 EoE symptoms were measured. HRQoL was measured with the Pediatric Quality of Life Inventory parent proxy report, child self-report (CR), and Family Impact Module (FIM). Statistical analyses used mixed-effects modeling to test changes over time for child and family HRQoL. Results: Ninety-seven children were enrolled (ages 2-18 years, mean age 7.7 years +/- 4.8, 78% boys, 80% white). Baseline mean symptom number was 3.5 (standard deviation 2.3), and symptom severity was 5.5 (standard deviation, 4.5). HRQoL scores were significantly related to symptom scores (P < 0.001). EoE symptom severity decreased during the study (P = 0.03). Pediatric Quality of Life Inventory parent proxy Total and FIM Total scores improved from baseline to 6 months (respectively, adjusted means 78.4 vs 81.0, P = 0.0006; 68.9 vs 70.1, P = 0.03). Interactions with baseline symptom severity revealed that subjects with lowest symptom severity showed the most improved HRQoL scores (P = 0.0013). Conclusions: HRQoL improved during the course of evaluation and treatment, with positive changes being strongest for patients with less symptom severity at baseline.

Journal Title

Journal of Pediatric Gastroenterology and Nutrition

Volume

59

Issue/Number

3

Publication Date

1-1-2014

Document Type

Article

Language

English

First Page

308

Last Page

316

WOS Identifier

WOS:000341080700010

ISSN

0277-2116

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