The Reality of Patient-Reported Outcomes of Health-Related Quality of Life in an Italian Cohort of Patients with Inflammatory Bowel Disease: Results from a Cross-Sectional Study

Abstract

Inflammatory bowel disease (IBD) has a negative impact on patients’ physical and psychological well-being, social performance, and working capacity, thereby worsening their health-related quality of life (HRQoL). Clinicians should take care of the patients’ global health, including the psychological, social, and emotional spheres. We aimed to investigate the reality of patient-reported outcomes of HRQoL in a series of IBD patients. Consecutive Crohn´s disease (CD) and ulcerative colitis (UC) patients in clinical remission were recruited. The survey consisted of the Short Inflammatory Bowel Disease Questionnaire (S-IBDQ), the Hospital Anxiety and Depression Scale (HADS), the Brief Illness Perception Questionnaire (B-IPQ), and a questionnaire dealing with impact of IBD on patients’ lives. Demographic and clinical characteristics were recorded. Of 202 participants (29% CD and 71% UC; 54% male; median age 48 years; mean disease duration 14 ± 11 years), 52% had poor HRQoL, 45% anxiety/depression, and 35% sleep disturbance and a high perception of disease (mean score 42.8 ± 14.3). In the multivariate analysis, a low HRQoL was rather associated with UC than CD (p = 0.037), IBD surgery (p = 0.010), disease duration (p = 0.01), sleep disturbance (p = 0.014), anxiety/depression (p = 0.042), and high illness perception (p = 0.006). IBD affected working performance and social activities in 62% and 74% of patients, respectively. Satisfaction regarding quality of care, biologics, and surgery approach were claimed in 73%, 69%, and 76% of patients, respectively. Although 84% of patients trusted their gastroenterologist, only 66% of them discussed IBD impact on HRQoL during visit. In a series of IBD patients in remission, the low HRQoL was significantly associated with surgery, disease duration, sleep disturbance, anxiety/depression, and high illness perception. Even though patients were satisfied with the quality of their care, it appears that clinicians should pay more attention to patients’ emotional status.

Anxiety and Gastrointestinal Symptoms Related to COVID-19 during Italian Lockdown

“…Literature supports the association between anxiety and gastrointestinal symptoms (GISs) [ 10 , 11 ]. In subjects with functional gastrointestinal disorders, such as dyspepsia and irritable bowel syndrome, the presence of anxiety seems to play a major role in the genesis and the perception of symptoms [ 12 ].…”

Physical Activity Reduction and the Worsening of Gastrointestinal Health Status during the Second COVID-19 Home Confinement in Southern Italy

“…Remarkably, the METS decreased in subjects with severe GSRS symptoms. This reduction could be attributed to different reasons, such as stress factors [ 31 , 32 , 33 , 34 ], new conditions imposed by the constraint period, overtraining, or incorrect training [ 8 , 35 ]. Due to these conditions, the possible drop-out can explain the continuous reduction of METs, even in the observed post-home confinement period.…”

Construction of an Explanatory Model for Quality of Life in Outpatients with Ulcerative Colitis

“…Previous studies have shown that the health-related quality of life (HRQoL) of patients with ulcerative colitis is considerably lower than that of the general population [2–4]. In addition, factors related to the quality of life of these patients are age at onset [5], age [6], sex [4, 6–8], disease activity [2, 3, 7, 9–14], disease type [3, 13], disease duration [15], anxiety [4, 12, 15], depression [2, 4, 12, 14, 15], psychological stress [8, 12], occupation [5, 9, 16], workplace support [17], and social life [18, 19]. Fu et al [20] examined the association between disease activity, social support, and HRQoL in patients with inflammatory bowel disease (IBD).…”