TY - JOUR
T1 - Self-reported disability in patients with inflammatory bowel disease largely determined by disease activity and illness perceptions
AU - van der Have, Mike
AU - Fidder, Herma H
AU - Leenders, Max
AU - Kaptein, Ad A
AU - van der Valk, Mirthe E
AU - van Bodegraven, Ad A
AU - Dijkstra, Gerard
AU - de Jong, Dirk J
AU - Pierik, Marieke
AU - Ponsioen, Cyriel Y
AU - van der Meulen-de Jong, Andrea E
AU - van der Woude, C Janneke
AU - van de Meeberg, Paul C
AU - Romberg-Camps, Mariëlle J L
AU - Clemens, Cees H M
AU - Jansen, Jeroen M
AU - Mahmmod, Nofel
AU - Bolwerk, Clemens J M
AU - Vermeijden, J Reinoud
AU - Siersema, Peter D
AU - Oldenburg, Bas
PY - 2015/2
Y1 - 2015/2
N2 - BACKGROUND: The inflammatory bowel disease (IBD) disability index has recently been introduced to measure patients' physical, psychological, familial, and social limitations associated with IBD. We assessed factors related to self-reported disability and the relationship between disability and direct health care costs.METHODS: A large cohort of patients with Crohn's disease (CD) and ulcerative colitis (UC) was prospectively followed for 2 years by 3 monthly web-based questionnaires. At 2 years, patients completed the IBD disability index, with lower score indicating more disability. Linear regression analysis was used to examine the impact of demographics, clinical characteristics, and illness perceptions on self-reported disability. Trends in direct health care costs across the disability severity groups minimal, mild, moderate, and severe, were tested.RESULTS: A total of 554 patients with CD and 424 patients with UC completed the IBD disability index (response rate, 45%). Both clinical characteristics and illness perceptions significantly contributed to self-reported disability (45%-47%, P = 0.000 and 8%-12%, P = 0.000, respectively). Patients with CD scored lower on the self-reported IBD disability index than patients with UC (0.255 versus 3.890, P < 0.000), indicating more disability in patients with CD. Factors independently associated with higher self-reported disability rates were increased disease activity, illness identity (higher number of symptoms attributed to IBD), and stronger emotional response. Disease duration and disease phenotype were not associated with self-reported disability. Direct health care costs increased with the worsening of self-reported disability (P = 0.000).CONCLUSIONS: More disability was reported by patients with CD than by UC. Self-reported disability in IBD was mainly determined by clinical disease activity and illness perceptions but not by disease duration or disease phenotype.
AB - BACKGROUND: The inflammatory bowel disease (IBD) disability index has recently been introduced to measure patients' physical, psychological, familial, and social limitations associated with IBD. We assessed factors related to self-reported disability and the relationship between disability and direct health care costs.METHODS: A large cohort of patients with Crohn's disease (CD) and ulcerative colitis (UC) was prospectively followed for 2 years by 3 monthly web-based questionnaires. At 2 years, patients completed the IBD disability index, with lower score indicating more disability. Linear regression analysis was used to examine the impact of demographics, clinical characteristics, and illness perceptions on self-reported disability. Trends in direct health care costs across the disability severity groups minimal, mild, moderate, and severe, were tested.RESULTS: A total of 554 patients with CD and 424 patients with UC completed the IBD disability index (response rate, 45%). Both clinical characteristics and illness perceptions significantly contributed to self-reported disability (45%-47%, P = 0.000 and 8%-12%, P = 0.000, respectively). Patients with CD scored lower on the self-reported IBD disability index than patients with UC (0.255 versus 3.890, P < 0.000), indicating more disability in patients with CD. Factors independently associated with higher self-reported disability rates were increased disease activity, illness identity (higher number of symptoms attributed to IBD), and stronger emotional response. Disease duration and disease phenotype were not associated with self-reported disability. Direct health care costs increased with the worsening of self-reported disability (P = 0.000).CONCLUSIONS: More disability was reported by patients with CD than by UC. Self-reported disability in IBD was mainly determined by clinical disease activity and illness perceptions but not by disease duration or disease phenotype.
KW - Adult
KW - Colitis, Ulcerative
KW - Crohn Disease
KW - Disabled Persons
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Perception
KW - Prognosis
KW - Prospective Studies
KW - Quality of Life
KW - Self Report
KW - Severity of Illness Index
KW - Surveys and Questionnaires
U2 - 10.1097/MIB.0000000000000278
DO - 10.1097/MIB.0000000000000278
M3 - Article
C2 - 25569738
SN - 1078-0998
VL - 21
SP - 369
EP - 377
JO - Inflammatory bowel diseases
JF - Inflammatory bowel diseases
IS - 2
ER -