Inflammatory Bowel Diseases and School Absenteeism

Abstract

Objectives: Inflammatory bowel diseases (IBDs) are chronic diseases which negatively affect the schooling of children. The aim is to analyze school absenteeism and its causes in children followed for IBD. Methods: A prospective multicenter study of IBD patients aged from 5 to 18 years old, from September 2016 to June 2017. Data on absenteeism and its causes were collected via a monthly questionnaire completed by patients or their family by mail. The results were compared with existing data supplied by the school authorities (497 students without IBD divided by class). Results: A total of 106 patients (62 boys), median age of 14 (5–18), were included. The global response rate was 83.1%. The patients with IBD were absent an average of 4.8% ± 5.5% of school days during the school year, against 3.2% ± 1.6% for non IBD group (P = 0.034). Digestive disorders accounted for 34% of the causes of absenteeism. Approximately 27% of the absences were due to scheduled events (hospitalizations, endoscopy, or consultations). By excluding the absences for scheduled care, the rate of school absenteeism of patients with IBD is significantly lower than that of non-IBD group. Conclusion: Children with IBD are more frequently absent from school than non-IBD group. The main cause of school absenteeism appears to be associated with the disease itself. The share of scheduled absenteeism is quite large. The organization and scheduling of the patients’ care path must be a priority to maximally limit the negative impact of their disease on the patients’ schooling.

Children and young people with inflammatory bowel disease attend less school than their healthy peers

“…These findings are in line with other studies showing that children with IBD miss significantly more school than their healthy peers 25–27. Mackner et al 25 found that 20% of those with IBD missed >3 weeks of school (<92% attendance) compared with 4% of healthy adolescents, while Assa et al 26 found that the difference was greater, with 64% of those with IBD missing >3 weeks compared with 3% of healthy adolescents, although they had a relatively small sample of patients with IBD.…”

“…However, these data are hypothetical and would require validation by moving hospital appointments to outside school hours in a cohort. Similarly, Eloi et al 27 found after excluding absences for scheduled care, the rate of school absenteeism of patients with IBD was significantly lower than the non-IBD group.…”

“…This is revealed in the detailed review of the local hospital attendance data, with monoclonal therapy being the second most common reason for hospital attendance. Likewise, Eloi et al 27 showed greater absenteeism in those on biological treatment. This has implications for practice in terms of which type of monoclonal treatment is used and when infusions should take place (evenings or weekends).…”

“…In our study, 45.6% (77 patients) missed >3 weeks of school (<92% attendance). Nevertheless, Eloi et al 27 found that patients with IBD were absent 4.8 days per year on average, vs 3.2 for the non-IBD group.…”

“…Considerable differences in education exist between illnesses, although significant themes emerge across the spectrum, including worse school experiences, performance, outcomes and lowered attendance rates 14 24. Studies that specifically examine IBD also demonstrate these patients miss more school than their healthy peers,25–27 although this is not necessarily linked to poorer educational outcomes 28. Lower school/college attendance rates are correlated with disease, demographic and psychosocial variables 25 29 30.…”