Pediatric Rheumatology Online Journal → June 2003 → Health-Related Quality of Life, Disease Activity and Outcome Assessments→ Abstract #36

A LONGITUDINAL EVALUATION OF THE CHILDHOOD HEALTH ASSESSMENT QUESTIONNAIRE (CHAQ) IN JUVENILE IDIOPATHIC ARTHRITIS (JIA)

S. P. Tang,¹ C. A. J. Ryder,¹ J. E. McDonagh,¹ P. Whitworth,¹ T. R. Southwood.¹

¹Department of Rheumatology, Birmingham Children's Hospital-NHS Trust, Birmingham, United Kingdom

Abstract: The CHAQ is a validated outcome measure used in JIA clinical trials. Our aim of was to evaluate the utility of the CHAQ in an outpatient-based JIA population.
Methods: Data was collected from 210 JIA patients from 1999-2002, in 88 of whom longitudinal data (at least 2 CHAQ scores 6 months apart) were available. Demographic, disease classification and treatment data were also recorded (NB: treatment changes were made independently of CHAQ scoring). Descriptive and univariate ANOVA statistical methods were used.
Results: Initial CHAQ scores ranged from 0-2.5. Differences between JIA subtypes were apparent; e.g persistent oligoarthritis (n=27) mean initial CHAQ score = 0.51 vs 1.29 for systemic arthritis (n=17,p=0.004). No relationship was observed between CHAQ scores and disease duration or patient age. For the JIA group as a whole, there was a reduction in mean CHAQ score of 0.11 points between 0 and 6 months; this improvement was greatest in systemic arthritis (0.29 points). A positive correlation between the change in CHAQ score and change in patient/parent assessment of overall wellbeing was noted (Pearson correlation 0.53, p0.001). Of the 88 JIA patients, 21(24%) demonstrated no change in CHAQ score, 45(51%) improved and 22 (25%) deteriorated. At 6 months, the majority of patients (n=13, 59%) in the deteriorating CHAQ group had their treatment escalated, whereas most patients in the stable or improving groups had no change or a reduction in their treatment (n=53, 80%). This association was statistically significant (p=0.005).
Conclusions: The CHAQ appears to be sensitive to change and consistent with other parameters of patient wellbeing in JIA. For JIA subgroups, differences in initial CHAQ scores and rates of improvement reflected the intuitive differences in disease severity. Appropriate alterations in treatment regimens appeared to parallel changes in CHAQ scores. This study supports the potential role of the CHAQ in routine clinical management of JIA patients.