Harnessing interactive technologies to improve health outcomes in juvenile idiopathic arthritis
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Date
2017-05-16Author
Coda, Andrea
Sculley, Dean
Santos, Derek
Girones, Xavier
Brosseau, Lucie
Smith, Derek R.
Burns, Joshua
Rome, Keith
Munro, Jane
Singh-Grewal, Davinder
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Coda, A., Sculley, D., Santos, D., Girones, X., Brosseau, L., Smith, D., Burns, J., Rome, K., Munro, J. & Singh-Grewal, D. (2017) Harnessing interactive technologies to improve health outcomes in juvenile idiopathic arthritis, Pediatric Rheumatology, vol. 15, , ,
Abstract
Background: Children and adolescents with Juvenile Idiopathic Arthritis (JIA) typically have reduced physical
activity level and impaired aerobic and anaerobic exercise capacity when compared to their non-JIA counterparts.
Low intensity exercise regimens appear to be safe in children with JIA and may results in improvements in overall
physical function. Poor adherence to paediatric rheumatology treatment may lead to negative clinical outcomes
and possibly increased disease activity. This includes symptoms such as pain, fatigue, quality of life, longer term
outcomes including joint damage, as well as increase of healthcare associated costs. Low adherence to medications
such as methotrexate and biological-drugs remains a significant issue for paediatric rheumatologists, with alarming
reports that less than half of the children with JIA are compliant to drug-therapy.
Main body: The recent advances in interactive technology resulting in a variety of wearable user-friendly smart
devices may become a key solution to address important questions in JIA clinical management. Fully
understanding the impact that arthritis and treatment complications have upon individual children and their
families has long been a challenge for clinicians. Modern interactive technologies can be customised and accessed
directly in the hands or wrists of children with JIA. These secured networks could be accessible 'live' at anytime and
anywhere by the child, parents and clinicians.
Multidisciplinary teams in paediatric rheumatology may benefit from adopting these technologies to better
understand domains such as patient biological parameters, symptoms progression, adherence to drug-therapy,
quality of life, and participation in physical activities. Most importantly the use of smart devices technologies may
also facilitate more timely clinical decisions, improve self-management and parents awareness in the progression of
their child's disease. Paediatric rheumatology research could also benefit from the use of these smart devices, as
they would allow real-time access to meaningful data to thoroughly understand the disease-patterns of JIA, such as
pain and physical activity outcomes. Data collection that typically occurs once every 1 or 3 months in the clinical
setting could instead be gathered every week, day, minute or virtually live online. Arguably, few limitations in
wearing such interactive technologies still exist and require further developments.
Conclusion: Finally, by embracing and adapting these new and now highly accessible interactive technologies,
clinical management and research in paediatric rheumatology may be greatly advanced.