Literature DB >> 25559754

Predictors of health-related quality of life and adherence in Crohn's disease and ulcerative colitis: implications for clinical management.

Anilga Tabibian1, James H Tabibian, Linda J Beckman, Laura L Raffals, Konstantinos A Papadakis, Sunanda V Kane.   

Abstract

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is associated with impaired health-related quality of life (HRQOL) and adherence. Our aim was to identify demographic, clinical, and psychosocial predictors of impaired HRQOL and non-adherence to provider recommendations.
METHODS: Adults with Crohn's disease (CD) or ulcerative colitis (UC) residing within the USA were recruited from online IBD support groups for participation in this cross-sectional study. Data were collected online through standardized instruments, including the Inflammatory Bowel Disease Questionnaire and the Medical Outcomes Study (MOS) general adherence scale. Bivariate analyses and multivariate linear regression were used to assess predictors of HRQOL and adherence.
RESULTS: We recruited 136 individuals, among whom median age was 35 years (range 18-75), and 82 % were female. 57 % had CD, and 43 % had UC. Predictors of lower HRQOL among CD patients were perceived stress (p < 0.0001), number of CD relapses (p < 0.0001), and female gender (p = 0.0015), while among UC patients they were perceived stress (p < 0.0001) and number of UC relapses (p = 0.0017). Predictors of lower adherence to provider recommendations in CD were perceived stress (p = 0.0007) and older age (p = 0.041), while in UC, perceived stress was the only predictor of lower adherence (p = 0.022).
CONCLUSIONS: Among patients with IBD, a higher level of perceived stress is a strong predictor of lower HRQOL and lower adherence to provider recommendations. Additionally, females with CD and patients with higher number of IBD relapses may be at risk of lower HRQOL. Psychological interventions, including physician-facilitated conversations, psychological screeners, and a multidisciplinary approach, may help address impaired HRQOL and adherence and merit further study.

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Year:  2015        PMID: 25559754     DOI: 10.1007/s10620-014-3471-1

Source DB:  PubMed          Journal:  Dig Dis Sci        ISSN: 0163-2116            Impact factor:   3.199


  44 in total

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Review 2.  British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults.

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4.  ACG Clinical Guideline: Management of Crohn's Disease in Adults.

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Authors:  Li-Ming Chen; Chun-Hui Bao; Yu Wu; Shi-Hua Liang; Di Wang; Lu-Yi Wu; Yan Huang; Hui-Rong Liu; Huan-Gan Wu
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