title: Health-related quality of life over time in children with eosinophilic esophagitis and their families.
abstract: OBJECTIVE
  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.
authors.affiliation: *National Jewish Health, Denver, and University of Colorado School of Medicine, Aurora †National Jewish Health, Denver and University of Colorado School of Public Health, Aurora ‡Digestive Health Institute, Gastrointestinal Eosinophilic Diseases Program, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora §National Jewish Health, Denver and Children's Hospital Colorado and University of Colorado School of Medicine, Aurora ||Rady Children's Hospital and University of California, San Diego ¶Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Philadelphia #Division of Gastroenterology, Hepatology, and Nutrition, Nemours Children's Hospital and University of Central Florida College of Medicine, Orlando.
authors.forename: Mary D
authors.initials: MD
authors.lastname: Klinnert
authors.forename: Lori
authors.initials: L
authors.lastname: Silveira
authors.forename: Rachel
authors.initials: R
authors.lastname: Harris
authors.forename: Wendy
authors.initials: W
authors.lastname: Moore
authors.forename: Dan
authors.initials: D
authors.lastname: Atkins
authors.forename: David M
authors.initials: DM
authors.lastname: Fleischer
authors.forename: Calies
authors.initials: C
authors.lastname: Menard-Katcher
authors.forename: Seema
authors.initials: S
authors.lastname: Aceves
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Spergel
authors.forename: James P
authors.initials: JP
authors.lastname: Franciosi
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Furuta
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D001249:Asthma / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004485:Eczema / Q000150:complications; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy* / Q000523:psychology; D005190:Family / Q000523:psychology*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications; D006304:Health Status; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D065631:Rhinitis, Allergic / Q000150:complications; D012720:Severity of Illness Index; D013256:Steroids / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D013256:Steroids