Diagnosis and Treatment of Systemic Juvenile Idiopathic Arthritis (sJIA) in Pediatric Age Groups

▪️Resource barriers
Treatment guidelines are hard to implement in daily practice due to a lack of resources of patients particularly the cost of biologic therapy
▪️System barriers
Treatment guidelines are not approved by official bodies e.g. MOH
▪️Attitudinal barriers
              Physicians’ autonomy in practice using their usual approach.
              Disagreement of Senior Pediatrician with the guidelines recommendations.
               Treatment guidelines may limit flexibility and individual approach.

Patient barriers

Patients do not want doctors to conform to treatment guidelines (expensive medication, for fear of side effects)

In addition, Lack of relevant national data or JIA registry disable our estimates for diagnostic and management difficulties. We have no multicenter studies from which reasonable conclusion could be derived and included in the recommendations.

There is no financial funding from any source for our EPG project till now which of course limit our ability for research, developing evidence-based recommendations and doing an effective implementation plan.

Some of the relevant international guidelines did not grant permission for adaptation or did not respond. Others may ask for a paid adaptation permission which is unaffordable.