Impact of Treatment on Quality of Life in Pediatric Patients with Eosinophilic Esophagitis

Abstract

The Pediatric Quality of Life (QOL) Inventory TM (PedsQL) survey measures health-related QOL in children with chronic health conditions. The primary purpose of this study is to examine QOL in pediatric patients with eosinophilic esophagitis (EoE) at their initial clinic visit based on their pre-visit treatment. METHODS: The PedsQL survey was given to 107 children aged 4-18 years referred for food allergies or EoE seen for initial consultation in the Texas Children's Hospital Allergy/Immunology Clinic from October 2014-September 2017. Measured outcomes included physical, social, emotional, and school functioning domain scores. Higher scores correlate with better QOL. Independent t-tests, Fisher's exact tests, Chi-square tests and multiple logistic regression were used for analysis. RESULTS: Twenty-four child surveys were completed at initial visit with an EoE diagnosis. Prior to initial visit, 19 were treated with elimination diet, 9 with steroids, and 15 with proton pump inhibitors (PPI). Children treated with PPIs had an initial school functioning score 16 points lower (95% CI:-28.77,-3.23) than those who were not treated with PPIs. No statistically significant differences were found in the other domains between those treated with diet, steroids, and/or PPIs versus untreated children. CONCLUSIONS: In this study, QOL survey scores were significantly lower in patients with EoE who were treated with PPI prior to initial allergy clinic visits. This finding may be related to symptom severity, the burden of taking medications, or lack of improvement on medication. Further investigation is warranted to address what drives the initial low QOL score in PPI-treated patients.