Mike van der Have1, Herma H Fidder, Max Leenders, Ad A Kaptein, Mirthe E van der Valk, Ad A van Bodegraven, Gerard Dijkstra, Dirk J de Jong, Marieke Pierik, Cyriel Y Ponsioen, Andrea E van der Meulen-de Jong, C Janneke van der Woude, Paul C van de Meeberg, Mariëlle J L Romberg-Camps, Cees H M Clemens, Jeroen M Jansen, Nofel Mahmmod, Clemens J M Bolwerk, J Reinoud Vermeijden, Peter D Siersema, Bas Oldenburg. 1. 1Department of Gastroenterology and Hepatology, University Medical Center Utrecht, the Netherlands; 2Medical Psychology Section, Leiden University Medical Center, Leiden, the Netherlands; 3Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands; 4Department of Gastroenterology and Hepatology, Orbis Medical Center, Sittard, the Netherlands; 5Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands; 6University of Groningen, Groningen, the Netherlands; 7Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; 8Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, the Netherlands; 9Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands; 10Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands; 11Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands; 12Department of Gastroenterology and Hepatology, Slingeland Hospital, Doetinchem, the Netherlands; 13Department of Gastroenterology and Hepatology, Diaconessenhuis, Leiden, the Netherlands; 14Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; 15Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands; 16Department of Gastroenterology and Hepatology, Reinier de Graaf Groep, Delft, the Netherlands; and 17Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands.
Abstract
BACKGROUND: The inflammatory bowel disease (IBD) disability index has recently been introduced to measure patients' physical, psychological, familial, and social limitations associated with IBD. We assessed factors related to self-reported disability and the relationship between disability and direct health care costs. METHODS: A large cohort of patients with Crohn's disease (CD) and ulcerative colitis (UC) was prospectively followed for 2 years by 3 monthly web-based questionnaires. At 2 years, patients completed the IBD disability index, with lower score indicating more disability. Linear regression analysis was used to examine the impact of demographics, clinical characteristics, and illness perceptions on self-reported disability. Trends in direct health care costs across the disability severity groups minimal, mild, moderate, and severe, were tested. RESULTS: A total of 554 patients with CD and 424 patients with UC completed the IBD disability index (response rate, 45%). Both clinical characteristics and illness perceptions significantly contributed to self-reported disability (45%-47%, P = 0.000 and 8%-12%, P = 0.000, respectively). Patients with CD scored lower on the self-reported IBD disability index than patients with UC (0.255 versus 3.890, P < 0.000), indicating more disability in patients with CD. Factors independently associated with higher self-reported disability rates were increased disease activity, illness identity (higher number of symptoms attributed to IBD), and stronger emotional response. Disease duration and disease phenotype were not associated with self-reported disability. Direct health care costs increased with the worsening of self-reported disability (P = 0.000). CONCLUSIONS: More disability was reported by patients with CD than by UC. Self-reported disability in IBD was mainly determined by clinical disease activity and illness perceptions but not by disease duration or disease phenotype.
BACKGROUND: The inflammatory bowel disease (IBD) disability index has recently been introduced to measure patients' physical, psychological, familial, and social limitations associated with IBD. We assessed factors related to self-reported disability and the relationship between disability and direct health care costs. METHODS: A large cohort of patients with Crohn's disease (CD) and ulcerative colitis (UC) was prospectively followed for 2 years by 3 monthly web-based questionnaires. At 2 years, patients completed the IBD disability index, with lower score indicating more disability. Linear regression analysis was used to examine the impact of demographics, clinical characteristics, and illness perceptions on self-reported disability. Trends in direct health care costs across the disability severity groups minimal, mild, moderate, and severe, were tested. RESULTS: A total of 554 patients with CD and 424 patients with UC completed the IBD disability index (response rate, 45%). Both clinical characteristics and illness perceptions significantly contributed to self-reported disability (45%-47%, P = 0.000 and 8%-12%, P = 0.000, respectively). Patients with CD scored lower on the self-reported IBD disability index than patients with UC (0.255 versus 3.890, P < 0.000), indicating more disability in patients with CD. Factors independently associated with higher self-reported disability rates were increased disease activity, illness identity (higher number of symptoms attributed to IBD), and stronger emotional response. Disease duration and disease phenotype were not associated with self-reported disability. Direct health care costs increased with the worsening of self-reported disability (P = 0.000). CONCLUSIONS: More disability was reported by patients with CD than by UC. Self-reported disability in IBD was mainly determined by clinical disease activity and illness perceptions but not by disease duration or disease phenotype.
Authors: S J H van Erp; L K M P Brakenhoff; M Vollmann; D van der Heijde; R A Veenendaal; H H Fidder; D W Hommes; A A Kaptein; Andrea E van der Meulen-de Jong; M Scharloo Journal: Int J Behav Med Date: 2017-04
Authors: Da Eun Jeong; Kyeong Ok Kim; Byung Ik Jang; Eun Young Kim; Jin Tae Jung; Seong Woo Jeon; Hyun Seok Lee; Eun Soo Kim; Kyung Sik Park; Kwang Bum Cho Journal: Medicine (Baltimore) Date: 2016-06 Impact factor: 1.889