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

    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

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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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