Health-related quality of life of youth with inflammatory bowel disease

Kunz, Jennifer; Hommel, Kevin A.; Greenley, Rachel Neff

doi:10.1002/ibd.21128

Cited by 72 publications

(33 citation statements)

References 27 publications

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“…23 Nevertheless, the PedsQL 4.0 has been frequently used in pediatric IBD research and allows for comparison with normative data and across disease groups. 35-40 There is the potential for underreporting of healthcare utilization given that outcome measures for the current study were limited to the participating hospital and could not account for additional visits to the family's pediatrician, urgent care clinics, or other health providers. Similarly, if patients report poor HRQOL during a GI clinic visit and are referred for additional services (i.e., psychological or pain management), there is the potential for bias and underreporting during subsequent visits.…”

Section: Discussionmentioning

confidence: 99%

“…This is consistent with studies demonstrating that even moderate concordance between youth and parent reports of HRQOL using the PedsQL substantiates the ideal use of multiple informants and allows for proxies when estimations are needed. 33,40 Moreover, a HRQOL screener should be selected that measures the perspectives of both the child and parent given that caregiver perceptions of their child's functioning often influence subsequent healthcare utilization. 45 Although there are numerous generic measures of HRQOL, the PedsQL 4.0 23 is a highly-used and psychometrically sound measure of HRQOL across several domains, allows for youth and parent proxy-report, and is easy to administer and score without disrupting clinic flow.…”

Section: Discussionmentioning

confidence: 99%

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The Clinical Utility of Health-Related Quality of Life Screening in a Pediatric Inflammatory Bowel Disease Clinic

Ryan

Mellon

Junger

et al. 2013

Inflammatory Bowel Diseases

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Background Adjusting to symptom flares, treatment regimens, and side effects places youth with inflammatory bowel disease (IBD) at increased risk for emotional and behavioral problems and adverse disease outcomes. Implementation of psychosocial screening into clinical practice remains a challenge. This study examines the clinical utility of health-related quality of life (HRQOL) screening in predicting disease outcome and healthcare utilization. Methods One-hundred twelve youth 7-18 years diagnosed with IBD and their parents. Youth completed standardized measures of HRQOL and depression. Parents completed a proxy-report of HRQOL. Pediatric gastroenterologists provided the Physician Global Assessment. Families were recruited from a pediatric gastroenterology clinic. Retrospective chart reviews examined disease outcome and healthcare utilization 12-months following baseline measurement. Results Linear regressions, controlling for demographic and disease parameters, revealed that baseline measurement of youth and parent proxy-reported HRQOL predicted the number of IBD-related hospital admissions, gastroenterology clinic visits, Emergency Department visits, psychology clinic visits, telephone contacts, and pain management referrals over the next 12 months. Disease outcome was not significant. Conclusions Lower HRQOL was predictive of increased healthcare utilization among youth with IBD. Regular HRQOL screening may be the impetus to providing better case management and allocating resources based on ongoing care needs and costs. Proactive interventions focused on patients with poor HRQOL may be an efficient approach to saving on healthcare costs and resource utilization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Clinical Utility of Health-Related Quality of Life Screening in a Pediatric Inflammatory Bowel Disease Clinic

Ryan

Mellon

Junger

et al. 2013

Inflammatory Bowel Diseases

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“…According to parent reports, adolescents with IBD have more emotional, social, and thought problems and lower competence than their healthy peers [35] . The disease disturbs adolescents' quality of life [25,36,37] , may have negative consequences for education and school functioning [38,39] , and may be a cause of difficulties in employment, such as finding or maintaining a desired job [40][41][42] . Furthermore, adolescents with severe IBD have disturbed sleep and are overtired tion to even minor cognitive problems that may be aggravated during the growth process [43,52,53] .…”

Section: Psychological Symptoms In Ibdmentioning

confidence: 99%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Inflammatory bowel disease; Psychiatry; Treatment; Personality traits; Depression; Anxiety Core tip: The involvement of a dysfunction of brain-gut interactions in the pathogenesis of inflammatory bowel disease (IBD) is represented by a dysfunction of the autonomic nervous system, an abnormal hypothalamicpituitary-adrenal axis and cholinergic anti-inflammatory pathway, a deleterious effect of stress and depression, an abnormal coupling of the prefrontal cortex-amygdaloid complex, and an abnormal relation between the microbiota and the brain as pro-inflammatory factors. New investigations have provided a critical link between forebrain changes and abdominal pain independent of active disease and drug treatment, providing a potential basis for an explanation of the psychological symptoms and brain influence in the pathogenesis of IBD.

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“…Perceived impairments in school functioning domains of HRQoL have been reported by adolescents with IBD and their parents relative to healthy youth, youth with other chronic illnesses, and acutely ill youth(47). Finally, one recent study offers evidence for poorer college adjustment among those with IBD relative to healthy controls and suggests that youth with active disease may be at particular risk for poor outcomes(91).…”

Section: School Functioningmentioning

confidence: 99%

Psychosocial Issues in Pediatric Inflammatory Bowel Disease

Mackner

Greenley²,

Szigethy³

et al. 2013

J. pediatr. gastroenterol. nutr.

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146

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Pediatric inflammatory bowel disease (IBD) can affect many areas of psychosocial functioning, and comprehensive medical care includes consideration of psychosocial issues as well as disease factors. The purpose of this clinical report is to review research on psychosocial functioning in pediatric IBD and to provide recommendations for care providers in the areas of psychopathology, health related quality of life and social, family and school functioning. Youth with IBD are at increased risk for difficulty in all areas reviewed, and many psychosocial factors are associated with disease activity, which highlights the importance of monitoring psychosocial functioning as part of clinical care. Several interventions have empirical support or show promise for addressing psychosocial difficulty, and recommendations for monitoring and treating these issues are provided.

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Health-related quality of life of youth with inflammatory bowel disease

Abstract: Background-This study compared youth and parent-proxy reports of health-related quality of life (HRQoL) among youth with inflammatory bowel disease (IBD) to published comparison group data and examined concordance between youth and parent-proxy reports of HRQoL.

Cited by 72 publications

References 27 publications

The Clinical Utility of Health-Related Quality of Life Screening in a Pediatric Inflammatory Bowel Disease Clinic

The Clinical Utility of Health-Related Quality of Life Screening in a Pediatric Inflammatory Bowel Disease Clinic

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Psychosocial Issues in Pediatric Inflammatory Bowel Disease

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