A New Approach to Clinical Care of Juvenile Idiopathic Arthritis

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A New Approach to Clinical Care of Juvenile Idiopathic Arthritis: The

Juvenile Arthritis Multidimensional Assessment Report

http://jrheum.org/content/early/2011/02/24/jrheum.100930.abstract

Address correspondence to Dr. A. Ravelli, Pediatria II, Istituto G. Gaslini,

Largo G. Gaslini 5, 16147 Genova, Italy. E-mail:

angelorav

Abstract

Objective To develop and test a new multidimensional questionnaire for

assessment of children with juvenile idiopathic arthritis (JIA) in standard

clinical care.

Methods The Juvenile Arthritis Multidimensional Assessment Report (JAMAR)

includes 15 parent or patient-centered measures or items that assess

well-being, pain, functional status, health-related quality of life, morning

stiffness, disease activity, disease status and course, joint disease,

extraarticular symptoms, side effects of medications, therapeutic

compliance, and satisfaction with illness outcome.

The JAMAR is proposed for use as both a proxy-report and a patient

self-report, with the suggested age range of 7–18 years for use as a

self-report.

From March 2007 to September 2009, the questionnaire was completed by the

parents of 618 children with JIA in 1814 visits and by 332 children in 749

visits.

Results The JAMAR was found to be feasible and to possess face and content

validity. All parents and children reported that the questionnaire was

simple and easy to understand. Completion and scoring appeared to be quick,

requiring < 15 minutes. There were very few missing data. Parents’

proxy-reported and children’s self-reported data were remarkably concordant.

The JAMAR provided thorough information for the study patients about recent

medical history and current health status. It performed similarly across

different children’s ages and characterized the level of disease activity

and disability well.

Conclusion The development of the JAMAR introduces a new approach in

pediatric rheumatology practice. This new questionnaire may help enhance the

quality of care of children with JIA.