Digestive Diseases and Sciences

, Volume 60, Issue 5, pp 1366–1374 | Cite as

Predictors of Health-Related Quality of Life and Adherence in Crohn’s Disease and Ulcerative Colitis: Implications for Clinical Management

  • Anilga Tabibian
  • James H. Tabibian
  • Linda J. Beckman
  • Laura L. Raffals
  • Konstantinos A. Papadakis
  • Sunanda V. Kane
Original Article

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.

Keywords

Inflammatory bowel disease Perceived stress Integrated care Patient education 

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Anilga Tabibian
    • 1
    • 2
  • James H. Tabibian
    • 3
  • Linda J. Beckman
    • 2
  • Laura L. Raffals
    • 3
  • Konstantinos A. Papadakis
    • 3
  • Sunanda V. Kane
    • 3
  1. 1.Department of Psychiatry and PsychologyMayo ClinicRochesterUSA
  2. 2.California School of Professional PsychologyAlhambraUSA
  3. 3.Division of Gastroenterology and HepatologyMayo ClinicRochesterUSA

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