Examination of the relationship between disease activity and patient reported outcome measures in an Inflammatory Bowel Disease cohort.

Abstract

The extent to which disease activity impacts on patient reported outcomes (PROs) is unclear. The purpose of this study was to examine the relationship between disease activity and PROs. Adult IBD patients attending a tertiary clinic from May to June 2015 were included. Assessment of disease activity (SCCAI, HBI), IBD knowledge (CCKNOW), medication adherence (MMAS8), psychological distress (HADS), work productivity (WPAI) and quality of life (IBDQ) was performed to investigate any correlations between disease activity and PROs. 81 participants were included: 49% female; 57% Crohn's Disease (CD); 38% ulcerative colitis (UC); 5% IBD-unclassified; median age 34. At least mild levels of depression were present in 21/81 (26%) of patients; 37/81 (46%) expressed some level of anxiety. A moderate-to-strong correlation was found between disease activity and depression in UC (r=0.84, p=0.002) but not in CD (r=0.53, p=0.29). Disease activity correlated with: overall work impairment due to health (r=0.85, p=0.001), health related impairment while working (r=0.76, p=0.02), and percentage of activity impaired due to health (r=0.83, p=0.002) in UC only. Disease activity significantly affects mood and work productivity in patients with UC. Monitoring patients' ability to function and work, rather than minimizing disease activity alone, should become a routine part of IBD care.