Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Aug 29, 2024
Open Peer Review Period: Sep 16, 2024 - Nov 11, 2024
Date Accepted: Jan 13, 2025
(closed for review but you can still tweet)
Digital Interventions for Patients with Juvenile Idiopathic Arthritis: A Systematic Review and Meta-analysis
ABSTRACT
Background:
Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic condition requiring long-term, multidisciplinary treatment, which consumes significant healthcare resources and family energy. This study aims to analyze the effectiveness of digital interventions on patient outcomes in individuals with JIA.
Objective:
This meta-analysis aims to evaluate the impact of digital interventions on alleviating symptoms and improving overall well-being in children and adolescents with JIA.
Methods:
A systematic search of five databases identified randomized controlled trials assessing the impact of digital interventions on physiological and psychological outcomes in adolescents and children (average age ≤ 19 years). Outcomes included pain, physical activity, health-related quality of life, self-efficacy, and disease-related issues. Two reviewers independently screened papers and extracted data on intervention functionalities and outcomes, assessing the risk of bias. A meta-analysis using a random-effects model synthesized the results.
Results:
The review included 11 studies involving 885 JIA patients. Digital interventions included websites, telephone consultations, video conferences, applications, and interactive games, with durations over 8 weeks. Compared to conventional control groups, digital interventions were significantly effective in alleviating pain (SMD -0.19, 95% CI -0.35 to -0.04) and enhancing physical activity levels (SMD 0.37, 95% CI 0.06 to 0.69). Marginal improvements in health-related quality of life, self-efficacy, and disease-related issues were observed, but these did not reach statistical significance (SMD -0.04, 95% CI -0.19 to 0.11; SMD 0.05, 95% CI -0.11 to 0.20; SMD 0.09, 95% CI -0.11 to 0.29, respectively). The GRADE approach rated the quality of evidence for pain, health-related quality of life, self-efficacy, and disease-related issues as moderate, while the evidence quality for physical activity was assessed as low.
Conclusions:
Digital interventions can alleviate pain and enhance physical activity in JIA patients. However, given the limited sample size and high risk of bias in some studies, further high-quality research is needed to improve the treatment and management of JIA.
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