Participation in school and physical education in juvenile idiopathic arthritis in a Nordic long-term cohort study.


Journal

Pediatric rheumatology online journal
ISSN: 1546-0096
Titre abrégé: Pediatr Rheumatol Online J
Pays: England
ID NLM: 101248897

Informations de publication

Date de publication:
15 Jul 2019
Historique:
received: 02 05 2019
accepted: 12 06 2019
entrez: 17 7 2019
pubmed: 17 7 2019
medline: 22 1 2020
Statut: epublish

Résumé

The aim of the study was to describe school attendance and participation in physical education in school among children with juvenile idiopathic arthritis (JIA). Consecutive cases of JIA from defined geographical areas of Finland, Sweden and Norway with disease onset in 1997 to 2000 were followed for 8 years in a multi-center cohort study, aimed to be as close to population-based as possible. Clinical characteristics and information on school attendance and participation in physical education (PE) were registered. Participation in school and in PE was lowest initially and increased during the disease course. Eight years after disease onset 228/274 (83.2%) of the children reported no school absence due to JIA, while 16.8% reported absence during the last 2 months due to JIA. Full participation in PE was reported by 194/242 (80.2%), partly by 16.9%, and none by 2.9%. Lowest participation in PE was found among children with ERA and the undifferentiated categories. Absence in school and PE was associated with higher disease activity measures at the 8-year visit. School absence > 1 day at baseline predicted use of disease-modifying anti-rheumatic drugs, including biologics (DMARDs) (OR 1.2 (1.1-1.5)), and non-remission off medication (OR 1.4 (1.1-1.7) 8 years after disease onset. School absence at baseline predicted adverse long-term outcome. In children and adolescents with JIA participation in school activities is mostly high after 8 years of disease. For the minority with low participation, special attention is warranted to promote their full potential of social interaction and improve long-term outcome.

Sections du résumé

BACKGROUND BACKGROUND
The aim of the study was to describe school attendance and participation in physical education in school among children with juvenile idiopathic arthritis (JIA).
METHODS METHODS
Consecutive cases of JIA from defined geographical areas of Finland, Sweden and Norway with disease onset in 1997 to 2000 were followed for 8 years in a multi-center cohort study, aimed to be as close to population-based as possible. Clinical characteristics and information on school attendance and participation in physical education (PE) were registered.
RESULTS RESULTS
Participation in school and in PE was lowest initially and increased during the disease course. Eight years after disease onset 228/274 (83.2%) of the children reported no school absence due to JIA, while 16.8% reported absence during the last 2 months due to JIA. Full participation in PE was reported by 194/242 (80.2%), partly by 16.9%, and none by 2.9%. Lowest participation in PE was found among children with ERA and the undifferentiated categories. Absence in school and PE was associated with higher disease activity measures at the 8-year visit. School absence > 1 day at baseline predicted use of disease-modifying anti-rheumatic drugs, including biologics (DMARDs) (OR 1.2 (1.1-1.5)), and non-remission off medication (OR 1.4 (1.1-1.7) 8 years after disease onset.
CONCLUSION CONCLUSIONS
School absence at baseline predicted adverse long-term outcome. In children and adolescents with JIA participation in school activities is mostly high after 8 years of disease. For the minority with low participation, special attention is warranted to promote their full potential of social interaction and improve long-term outcome.

Identifiants

pubmed: 31307487
doi: 10.1186/s12969-019-0341-6
pii: 10.1186/s12969-019-0341-6
pmc: PMC6631827
doi:

Substances chimiques

Antirheumatic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

44

Subventions

Organisme : Helse Nord RHF
ID : HNF 1450-19

Investigateurs

Gudmund Marhaug (G)
Freddy Karup Pedersen (FK)
Pekka Lahdenne (P)
Boel Anderson-Gäre (B)

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Auteurs

Ellen Nordal (E)

Department of Pediatrics, University Hospital of North Norway, 9038, Tromsø, Norway. ellen.nordal@unn.no.
Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway. ellen.nordal@unn.no.

Veronika Rypdal (V)

Department of Pediatrics, University Hospital of North Norway, 9038, Tromsø, Norway.
Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway.

Ellen Dalen Arnstad (ED)

Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
Department of Pediatrics, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.

Kristiina Aalto (K)

Children's Hospital, University of Helsinki, Helsinki, Finland.

Lillemor Berntson (L)

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Maria Ekelund (M)

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Pediatrics, Ryhov County Hospital, Jonkoping, Sweden.

Anders Fasth (A)

Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Mia Glerup (M)

Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.

Troels Herlin (T)

Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.

Susan Nielsen (S)

Department of Pediatrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.

Suvi Peltoniemi (S)

Children's Hospital, University of Helsinki, Helsinki, Finland.

Marek Zak (M)

Department of Pediatrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.

Nils Thomas Songstad (NT)

Department of Pediatrics, University Hospital of North Norway, 9038, Tromsø, Norway.
Department of Clinical Medicine, UIT the Arctic University of Norway, Tromsø, Norway.

Marite Rygg (M)

Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway.

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