Health-related quality of life in spanish crohn disease patients

Abstract

Background: Crohn disease (CD) is a chronic inflammatory bowel process which primarily affects young adults. The disabilities related to the symptoms and complications of CD affect the physical, social, and emotional well-being of patients, and significantly decrease the health-related quality of life (HRQoL). HRQoL is associated with the disease activity, surgery and medical treatment, the degree of patient's concern, and the productivity among others. The aim of our study was to determine how CD affects HRQoL, work productivity and psychological well-being in a large sample of CD patients in Spain. Methods: Spanish multicentre, cross-sectional observational study. Patients with CD were recruited between 2009 and 2010 through the Spanish CD patient association and by gastroenterologists at their offices. In a single visit, patients provided information about socio-demographic and clinical data. To know the influence of the illness on the HRQoL they completed the “Inflammatory Bowel Disease Questionnaire” (IBDQ9). It was evaluated the correlation between the HRQoL and the clinical and socio-demographic variables recovered. For the correlation between the HRQoL and the work productivity, the patients completed the “Work Productivity and Activity Impairment Questionnaire” (WPAI). The “Overall Work Productivity Loss” (OWPL) and the “Daily Activities Impairment” (DAI) were also measured. Results: A total of 1688 patients were recruited: 64% were members of a CD association, 51% were females and the mean age was 42.5 (±SD 11.2). The 86.8% of patients had been diagnosed of CD more than two years before and the 19.1% underwent surgery in the previous two years. The IBDQ9 average score was 63.54 (±SD 9.78). There was a significant correlation between IBDQ9 and the different components of productivity: OWPL (r:-0.555), DAI (r:-0.657), presenteeism (r:-0.528) and absenteeism (r = 0.292). The OWPL was 26.9% and the mean DAI index was 35%. Most patients (68.3%) reported being concerned about future complications of their disease, which also was found of relevant influence on the HRQoL. However HRQoL was not related to the other sociodemographic and clinical variables evaluated. Conclusions: CD reduces the HRQoL. Work productivity and patient's concern about their illness and complications are significantly related with the HRQoL.