Impact of COVID-19 pandemic on the healthcare and psychosocial well-being of patients with inflammatory bowel disease

Abstract

COVID-19 pandemic has resulted in unprecedented disruptions to several aspects of gastroenterology healthcare services worldwide. In particular, patients with inflammatory bowel disease (IBD) represent a sensitive population that must retain access to healthcare services to avoid potential disease exacerbation under the continuous threat of viral infection. Emerging evidence also highlights the severe impact on these patients’ mental well-being, leading to a constant cycle of stress/depression and disease activity relapse. In an effort to circumvent these healthcare challenges in a newly-shaped environment, physicians implemented telemedicine consultative care programs as a novel alternative follow-up method highly favored by the patients. The situation is still far from perfect, since a large proportion of patients are lost to follow up and/or lose adherence to their medication, especially when the exact timeframe or optimal strategy for the post-COVID era remains to be defined. Cancelation of elective endoscopic procedures has led to a significant decline of new IBD diagnoses. This review summarizes the data on the global impact of COVID-19 on IBD patients’ healthcare and their psychosocial status.

A Comparison of the Effects of COVID-19 on Irritable Bowel Syndrome and Inflammatory Bowel Disease Patients While Working at Home and in the Office: A Retrospective Study

“…Increased stress levels during the pandemic era are particularly of concern in the subpopulation of individuals diagnosed with IBD and/or IBS because stress is a known factor to instigate IBS/IBD symptomatology [4,[8][9][10]. Interestingly, during the pandemic, it was also reported that IBD patients may have been more fearful about COVID-19 infection compared to other individuals [11]. As such, some studies suggested screening specific IBD patients (e.g., females or those aged 50-70 years old), due to their high risk of developing anxiety during the pandemic, which in turn may lead to vicious cycles of anxiety and higher disease activity [11,12].…”

“…Interestingly, during the pandemic, it was also reported that IBD patients may have been more fearful about COVID-19 infection compared to other individuals [ 11 ]. As such, some studies suggested screening specific IBD patients (e.g., females or those aged 50-70 years old), due to their high risk of developing anxiety during the pandemic, which in turn may lead to vicious cycles of anxiety and higher disease activity [ 11 , 12 ].…”

“…Concerns were also raised due to the high utilization of telemedicine (e.g., mobile applications or communication technologies) during the pandemic and that this might worsen IBD symptoms or psychology. However, no difference in psychological outcomes was noted when telemedicine was compared to standard care [ 11 , 21 , 25 ]. Our study again revealed that the majority of IBD patients had “at baseline” or improved symptoms.…”

“…Such a relationship was not observed in IBS patients. Other studies report vicious cycles of worsening psychological status and symptomatic worsening in IBD patients [ 11 ]. Especially, females and patients between 50 and 70 years old may be prone to worse levels of depression and should be screened [ 12 ].…”

Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions

“…The relationship between healthcare providers and patients has always been the cornerstone of healthcare for patients with IBD [ 24 ], and motivational interviewing has emerged as a key strategy for improving therapeutic adherence [ 25 ]. The conceptual framework of motivational interviewing was originally described by William Miller [ 26 ].…”