Over-reaching beyond disease activity: The influence of anxiety and medical economic burden on health-related quality of life in patients with inflammatory bowel disease

Xia Peng Luo, Ren Mao*, Bai Li Chen, Yun Qiu, Sheng Hong Zhang, Yao He, Jie Chen, Zhi Rong Zeng, Shomron Ben-Horin, Min Hu Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose: Many patients with inflammatory bowel disease (IBD) have impaired health-related quality of life (HRQOL). The influence of psychological and economic factors on HRQOL has not been fully elucidated in IBD. Therefore, we aimed to identify the predictors of HRQOL in an IBD cohort. Patients and methods: This was a cross-sectional cohort study of patients presenting to our tertiary IBD center. HRQOL was measured using the 36-item Short Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Perceived stress and perceived social support were also assessed by standardized scales. Demographic, socioeconomic and clinical data were obtained from a prespecified questionnaire and patients’ medical records. Univariate analyses and multiple regression analysis were performed to identify predictors of HRQOL. Results: A total of 242 IBD patients were recruited, and the questionnaire return rate was 90.5% (219/242). The prevalence rates of anxiety and depression were 24.7% and 17.4%, respectively. In all, 30.6% of the patients spent over half of their income to cover medical costs. Multivariate analysis revealed that anxiety symptoms (P<0.001), active disease (P<0.001) and higher medical expenditures (P=0.001) were strong and independent predictors of reduced HRQOL. Conclusion: Psychological factors and costs of medical care strongly impair HRQOL in IBD, independent of the disease activity. Psychological counseling and socioeconomic support programs should be considered for integration into the management of IBD patients.

Original languageEnglish
Pages (from-to)23-31
Number of pages9
JournalPatient Preference and Adherence
Volume11
DOIs
StatePublished - 2017

Funding

FundersFunder number
National Natural Science Foundation of China81500501, 81270473, 81470821

    Keywords

    • Anxiety
    • Crohn’s disease
    • Depression
    • Health-related quality of life
    • Inflammatory bowel disease
    • Stress

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