Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
J Crohns Colitis. 2015 Mar;9(3):276-83. doi: 10.1093/ecco-jcc/jju025. Epub 2014 Dec 28.
Back and joint pain are the most common extraintestinal symptoms reported by patients with inflammatory bowel disease (IBD). We assessed the impact of back/joint pain, illness perceptions, and coping on quality of life (QOL) and work productivity in patients with IBD.
Our cohort included 155 IBD patients with and 100 without arthropathy. Arthropathy was defined as daily back pain for ≥3 months and/or peripheral joint pain and/or joint swelling over the last year. At baseline and at 12 months, patients completed questionnaires on the extent of back/joint pain, IBD disease activity, illness perceptions, coping, QOL, and work productivity. The impact of back/joint pain, illness perceptions and coping on QOL and work productivity was determined, using linear mixed models.
In total, 204 IBD patients (72% Crohn's disease, 40% male, mean age 44 ± 14 years) completed questionnaires at both time points. At both time points, IBD patients with back/joint pain reported a significantly lower QOL and work productivity compared with IBD patients without back/joint pain. Predictors of low QOL were back/joint pain (β = -1.04, 95% confidence interval [CI] -1.40, -0.68), stronger beliefs about the illness consequences (β = -0.39, 95% CI -0.59, -0.18) and emotional impact of IBD (β = -0.47, 95% CI -0.66, -0.28), and the coping strategy 'decreasing activity' (β = -0.26, 95% CI -0.48, -0.03). Predictors of work productivity were back/joint pain (β = 0.22, 95% CI 0.07, 0.37) and illness consequences (β = 0.14, 95% CI 0.06, 0.22).
Back/joint pain, illness perceptions, and coping are significant predictors of QOL and work productivity, after controlling for disease activity.
背部和关节疼痛是炎症性肠病（IBD）患者最常见的肠道外症状。我们评估了背部/关节疼痛、疾病认知和应对方式对 IBD 患者生活质量（QOL）和工作生产力的影响。
我们的队列包括 155 例有和 100 例无关节炎的 IBD 患者。关节炎定义为过去 1 年中每日背部疼痛≥3 个月和/或外周关节疼痛和/或关节肿胀。在基线和 12 个月时，患者完成了关于背部/关节疼痛程度、IBD 疾病活动度、疾病认知、应对方式、QOL 和工作生产力的问卷。使用线性混合模型确定背部/关节疼痛、疾病认知和应对方式对 QOL 和工作生产力的影响。
共有 204 例 IBD 患者（72%克罗恩病，40%男性，平均年龄 44±14 岁）在两个时间点完成了问卷。在两个时间点，有背部/关节疼痛的 IBD 患者报告的 QOL 和工作生产力均明显低于无背部/关节疼痛的 IBD 患者。QOL 较低的预测因素为背部/关节疼痛（β=-1.04，95%置信区间[CI] -1.40，-0.68）、对疾病后果的信念较强（β=-0.39，95%CI -0.59，-0.18）和 IBD 的情绪影响（β=-0.47，95%CI -0.66，-0.28）以及“减少活动”的应对策略（β=-0.26，95%CI -0.48，-0.03）。工作生产力的预测因素为背部/关节疼痛（β=0.22，95%CI 0.07，0.37）和疾病后果（β=0.14，95%CI 0.06，0.22）。
在控制疾病活动度后，背部/关节疼痛、疾病认知和应对方式是 QOL 和工作生产力的重要预测因素。
