Digital Interventions for Patients with Juvenile Idiopathic Arthritis: A Systematic Review and Meta-analysis (Preprint)

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.