Patient discussions
Patients require regular follow-up, although those with oligoarticular JIA need less frequent follow-up once their disease is controlled. Children with polyarticular or systemic subtypes need more frequent follow-up (initially monthly or bi-monthly).
Patient and family education is an important aspect of therapy and helps to ensure concordance with treatment regimens. Concordance with home exercise programs should also be encouraged to preserve and improve range of motion. However, the long-term benefit of exercise is uncertain.[67] Psychological support for patients and their families can be helpful in promoting adherence to treatment and should be considered for all patients with long-term illness.[130]
Careful monitoring for drug side effects is crucial. Patients should be advised to inform their healthcare provider immediately if there are any signs of infection, especially persistent fevers.
Live viral vaccines are not recommended for patients on certain medicines, although killed vaccines are safe and annual influenza vaccination is recommended. Due to concerns about the safety of vaccines in JIA, clinicians must discuss with families the evidence that strongly supports their benefits and safety, ensuring where possible that local scheduled immunizations are adhered to.[73]
There is evidence that children with JIA and flat feet may benefit from custom-made foot orthoses.[69][131][132]
Patient information is available from the Arthritis Foundation and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Arthritis Foundation: juvenile idiopathic arthritis Opens in new window National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): juvenile arthritis Opens in new window
Physical and occupational therapy are encouraged in conjunction with medications.
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