New Standards of Care for JIA in Australia
Optimal care for patients with juvenile idiopathic arthritis (JIA) is now to be supported through the development of Key standards of care.
Standards of care have now been developed by Australian paediatric rheumatology specialists.
The standards of care have been developed through a collaborative effort of nine rheumatologists from across Australia, they are based on
international best practice, and are the first to be compiled for a specifically Australian audience.
Co-author Susan Piper says the guideline aims to educate a range of health professionals, including rheumatologists, paediatricians, orthopaedic
surgeons and GPs.
According to the guideline, health professionals should have “knowledge of defined and appropriate referral pathways for patients with suspected or diagnosed JIA”. Patients with a suspected or confirmed diagnosis of JIA should be assessed and offered management by a specialist paediatric rheumatology service within 4 weeks of referral or within 10 weeks of symptom onset.
Dr Piper says this task is hampered by the lack of knowledge by GPs and other health professionals about the condition. “There’s a window of opportunity in all inflammatory arthritis where early treatment results in the best chances of inciting long-term remission. . . . The longer the process has been going on, the less likely you’ll be able to achieve long-term remission and the possibility of coming off all medications,” she says.
Although Dr Piper says that knowledge has evolved over time. “When I started in this field, the idea was you wouldn’t give disease-modifying drugs to children under 12 months unless there was evidence of X-ray changes in the joints. . . . These days in that situation, you’ve really missed the boat.”
The standards focus on developing best practice for clinical care, including setting up a specialist multidisciplinary paediatric rheumatology service within six weeks of referral. Children with JIA should also have access to appropriate clinical assessments, pharmacological and non-pharmacological interventions, pain management, periodic clinical review and ophthalmology care. Although this has been identified as best practice, we know that there is a long way to go, particularly in rural and remote areas.
The guideline is set to be reviewed in May 2018.
Journal of Paediatrics and Child Health
Volume 50,
Issue 9, pages 663–666, September 2014
Australian Paediatric Rheumatology Group standards of care for the management of juvenile idiopathic arthritis
Abstract
This standards document outlines accepted standards of management for children, adolescents and young adults with juvenile idiopathic arthritis (JIA) in Australia. This document acknowledges that the chronic inflammatory arthritis conditions (JIA) in childhood are different diseases from inflammatory arthritis in adults and that specific expertise is required in the care of children with arthritis.
Jane Munro, Kevin Murray, Christina Boros, Jeffrey Chaitow, Roger C Allen, Jonathan Akikusa, Navid Adib, Susan E Piper, Davinder Singh-Grewal an on behalf of the Australian Paediatric Rheumatology Group
Article first published online: 25 AUG 2014