TY - JOUR
T1 - Self-reported disability in patients with inflammatory bowel disease largely determined by disease activity and illness perceptions
AU - Van Der Have, Mike
AU - Fidder, Herma H.
AU - Leenders, Max
AU - Kaptein, Ad A.
AU - Van Der Valk, Mirthe E.
AU - Van Bodegraven, Ad A.
AU - Dijkstra, Gerard
AU - De Jong, Dirk J.
AU - Pierik, Marieke
AU - Ponsioen, Cyriel Y.
AU - Van Der Meulen-De Jong, Andrea E.
AU - Van Der Woude, C. Janneke
AU - Van Der Meeberg, Paul C.
AU - Romberg-Camps, Mariëlle J L
AU - Clemens, Cees H M
AU - Jansen, Jeroen M.
AU - Mahmmod, Nofel
AU - Bolwerk, Clemens J M
AU - Vermeijden, J. Reinoud
AU - Siersema, Peter D.
AU - Oldenburg, Bas
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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 webbased 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.
AB - 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 webbased 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.
KW - Determinants
KW - Health care costs
KW - IBD disability index
KW - Illness perceptions
UR - http://www.scopus.com/inward/record.url?scp=84924440981&partnerID=8YFLogxK
U2 - 10.1097/MIB.0000000000000278
DO - 10.1097/MIB.0000000000000278
M3 - Article
C2 - 25569738
AN - SCOPUS:84924440981
SN - 1078-0998
VL - 21
SP - 369
EP - 377
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
IS - 2
ER -