Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Taiwan Society of Inflammatory Bowel Disease (TSIBD), Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, IBD Center, Taichung Veterans General Hospital, Taichung City, Taiwan.
J Formos Med Assoc. 2023 Oct;122(10):1042-1049. doi: 10.1016/j.jfma.2023.03.017. Epub 2023 Mar 27.
The coronavirus disease 2019 (COVID-19) pandemic had a great impact on healthcare system and patients. This study aimed to evaluate the effect of the COVID-19 pandemic on the perceptions of patients with inflammatory bowel disease (IBD).
This prospective multicenter study was conducted between July 2021 and December 2021. Patients with IBD answered a structured questionnaire, and their degree of anxiety was assessed using a visual analogue scale (VAS) before and after reading educational materials.
A total of 225 (47.67%) patients with Crohn's disease, 244 (51.69%) with ulcerative colitis and 3 (0.64%) with indeterminate colitis were enrolled. Common concerns were adverse events from vaccination (20.34%), and higher risks of developing severe COVID-19 (19.28%) and COVID-19 infection (16.31%) than the general population. Medications deemed by the patients to increase the risk of COVID-19 were immunomodulators (16.10%), anti-tumor necrosis factor-α antagonists (9.96%), and corticosteroids (9.32%). Thirty-five (7.42%) patients self-discontinued IBD medication, of whom 12 (34.28%) had worse symptoms. Older age (>50 years) (OR 1.10, 95% CI 1.01-1.19, p = 0.03), IBD-related complications (OR 1.16, 95% CI 1.04-1.28, p = 0.01), education status below senior high school (OR 1.22, 95% CI 1.08-1.37, p = 0.001), and residing in north-central Taiwan (OR 1.21, 95% CI 1.10-1.34, p < 0.001) were associated with more anxiety. None of the enrolled patients contracted COVID-19. The anxiety VAS score (mean ± SD) improved after reading the educational materials (3.84 ± 2.33 vs. 2.81 ± 1.96, p < 0.001).
The medical behavior of IBD patients was influenced by the COVID-19 pandemic, and their anxiety could be mitigated after education.
2019 年冠状病毒病(COVID-19)大流行对医疗保健系统和患者产生了重大影响。本研究旨在评估 COVID-19 大流行对炎症性肠病(IBD)患者认知的影响。
这是一项前瞻性多中心研究,于 2021 年 7 月至 2021 年 12 月进行。IBD 患者回答了一份结构化问卷,并在阅读教育材料前后使用视觉模拟量表(VAS)评估其焦虑程度。
共纳入 225 例(47.67%)克罗恩病患者、244 例(51.69%)溃疡性结肠炎患者和 3 例(0.64%)不确定结肠炎患者。常见的担忧是疫苗接种的不良事件(20.34%),以及发生严重 COVID-19(19.28%)和 COVID-19 感染(16.31%)的风险高于一般人群。患者认为增加 COVID-19 风险的药物有免疫调节剂(16.10%)、抗肿瘤坏死因子-α拮抗剂(9.96%)和皮质类固醇(9.32%)。35 名(7.42%)患者自行停用 IBD 药物,其中 12 名(34.28%)症状恶化。年龄较大(>50 岁)(OR 1.10,95%CI 1.01-1.19,p=0.03)、IBD 相关并发症(OR 1.16,95%CI 1.04-1.28,p=0.01)、高中以下教育程度(OR 1.22,95%CI 1.08-1.37,p=0.001)和居住在台湾中北部(OR 1.21,95%CI 1.10-1.34,p<0.001)与焦虑程度更高相关。纳入的患者均未感染 COVID-19。阅读教育材料后,焦虑 VAS 评分(均值±标准差)改善(3.84±2.33 与 2.81±1.96,p<0.001)。
COVID-19 大流行影响了 IBD 患者的医疗行为,教育后可减轻其焦虑。