Anxiety and behavioral changes in Japanese patients with inflammatory bowel disease due to COVID-19 pandemic: a national survey

Abstract

Background Given the increasing health concerns for patients with inflammatory bowel disease (IBD), amidst the COVID-19 pandemic, we investigated the impact of the pandemic on the anxiety and behavioral changes in Japanese patients with IBD. Methods We analyzed 3032 questionnaires from patients with IBD, aged 16 years or older visiting 30 hospitals and 1 clinic between March 2020 and June 2021. The primary outcome was the score of the anxiety experienced by patients with IBD during the pandemic. Results Participants reported a median age of 44 years; 43.3% of the patients were women. Moreover, 60.6% and 39.4% were diagnosed with ulcerative colitis and Crohn’s disease, respectively, with a median disease duration of 10 years. Participants indicated an average of disease-related anxiety score of 5.1 ± 2.5 on a ten-point scale, with a tendency to increase, 1 month after the number of infected persons per population increased. The top three causes for anxiety were the risk of contracting COVID-19 during hospital visits, SARS-CoV-2 infection due to IBD, and infection by IBD medication. Factors associated with anxiety were gender (women), being a homemaker, hospital visit timings, mode of transportation (train), use of immunosuppressive drugs, and nutritional therapy. Most patients continued attending their scheduled hospital visits, taking their medications, experienced the need for a family doctor, and sought guidance and information regarding COVID-19 from primary doctors, television, and Internet news. Conclusions Patients with IBD experienced moderate disease-related anxiety due to the pandemic and should be proactively informed about infectious diseases to relieve their anxiety.

The impact of COVID‐19 on Japanese patients with eosinophilic gastrointestinal disorders during the vaccination era

“…Patients with asymptomatic COVID‐19 may have been missed in this study. Third, several studies have shown the psychological impact of COVID‐19 in patients with chronic diseases, such as inflammatory bowel diseases 35–37 . However, no data are available on this issue.…”

Impact of the COVID-19 Pandemic on the Lifestyle and Psychosocial Behavior of Patients with Inflammatory Bowel Diseases: A Narrative Review

“…In a survey conducted with the support of the European Federation of Crohn's and Ulcerative Colitis Association, 4% of the respondents stopped using IBD medication during the pandemic on their own [52]. Nakase et al reported that only 0.6% of patients discontinued therapy, 1.9% used medications at reduced doses, and 97.5% used medications as directed [63]. These results suggest that good adherence is possible despite the ongoing disruptions caused by the pandemic.…”

“…When infection rate is high, medication adherence is assumed to decline because of hospitals being closed or people not being able to visit hospitals; however, in cases where an epidemic has subsided, adherence is assumed to decline because of worsening mental status or other factors. Nakase et al reported that the most common reasons for discontinuing medications were "stable abdominal symptoms" (38.4%), "instructions from the attending physicians" (31.5%), and "a higher risk of contracting infection due to medication" (21.9%) [63]. Although physicians should communicate with patients to help them understand the necessity of continuing medication therapy, only 7% of the patients reported discussing their medication with their medical staff during the pandemic [66].…”

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“…At the outset of the COVID‐19 pandemic, patients may have been reluctant to visit hospitals for fear of SARS‐CoV‐2 infection. According to a survey of inflammatory bowel disease patients, 56.2% of patients were afraid to go to the hospital for fear of contracting SARS‐CoV‐2 11 . Healthcare providers were also concerned about the spread of infection through hospital visits and allowed a certain amount of delay in visits if necessary.…”