Health-Related Quality of Life in Pediatric Patients with Functional and Organic Gastrointestinal Diseases - 18/09/14

Doi : 10.1016/j.jpeds.2014.08.022

James W. Varni, PhD ^1,^2,^⁎ , Cristiane B. Bendo, PhD ³, Samuel Nurko, MD ⁴, Robert J. Shulman, MD ^5,⁶, Mariella M. Self, PhD ⁷, James P. Franciosi, MD ⁸, Miguel Saps, MD ⁹, John F. Pohl, MD ¹⁰
on behalf of the
Pediatric Quality of Life Inventory (PedsQL) Gastrointestinal Symptoms Module Testing Study Consortium^{^∗}
A list of PedsQL Gastrointestinal Symptoms Module Testing Study Consortium sites is available at www.jpeds.com/ (Appendix).
¹ Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX
² Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX
³ Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
⁴ Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, MA
⁵ Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
⁶ Children's Nutrition Research CenterBaylor College of Medicine, , Texas Children's Hospital, Houston, TX
⁷ Department of Psychiatry, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
⁸ Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
⁹ Division of Gastroenterology, Hepatology, and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
¹⁰ Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah, Salt Lake City, UT

^∗Reprint requests: James W. Varni, PhD, Professor of Architecture and Medicine, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX 77843-3137.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 18 September 2014

Abstract

Objective

To compare health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs) and organic gastrointestinal (GI) diseases with an age-, sex-, and race/ethnicity-matched healthy sample across GI diagnostic groups and with one another.

Study design

The Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 689 families. Patients had 1 of 7 physician-diagnosed GI disorders: chronic constipation, functional abdominal pain, irritable bowel syndrome, functional dyspepsia, Crohn's disease, ulcerative colitis, and gastroesophageal reflux disease. The healthy control sample included 1114 families. School days missed, days in bed and needing care, parent missed workdays, work impact, and healthcare utilization were compared as well.

Results

Patients with an FGID or organic GI disease demonstrated lower HRQOL than the healthy controls across all dimensions (physical, emotional, social, and school; P < .001 for all), with larger effect sizes for patients with an FGID. Patients with an FGID manifested lower HRQOL than those with an organic GI disease. Patients with an FGID or organic GI disease missed more school, spent more days in bed and needing care, had greater healthcare utilization, and had parents who missed more workdays with greater work impact (P < .001 for most), with larger effect sizes for the patients with an FGID.

Conclusion

Patients with an FGID or organic GI disease demonstrate impaired HRQOL compared with healthy children. HRQOL can be used as a common metric to compare patient outcomes in clinical research and practice both within and across groups of patients with FGIDs and organic GI diseases.

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Keyword : CC, CD, FAP, FD, FGID, GI, HRQOL, IBS, PedsQL

Plan

Internal Consistency Reliability

HRQOL Comparisons between GI Groups and Healthy Controls

Impact Items Comparisons Between GI Groups and Healthy Controls

Discussion

	J.F. is currently at the Division of Gastroenterology, Hepatology, and Nutrition, Nemours Children's Hospital, Orlando, FL.
	J.V. holds the copyright and the trademark for the PedsQL and receives financial compensation from the Mapi Research Trust, a nonprofit research institute that charges distribution fees to for-profit companies that use the PedsQL. The other authors declare no conflicts of interest.