Maladaptive coping, low self-efficacy and disease activity are associated with poorer patient-reported outcomes in inflammatory bowel disease

Abstract

Background/Aims: Patient-reported outcomes (PRO) are key aspects in the management of inflammatory bowel disease (IBD). This study aims to evaluate factors associated with adverse PRO, including modifiable social constructs of maladaptive coping and self-efficacy as well as physician–patient concordance on PRO. Patients and Methods: This cross-sectional study was performed in patients with Crohn's disease (CD) or ulcerative colitis (UC) from September 2015 to March 2016. Validated questionnaires were used to assess quality of life (Short IBD Questionnaire), disability (IBD disability index), productivity (work productivity and activity impairment questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale), coping strategies [Brief Coping Operations Preference Enquiry (Brief COPE)], and self-efficacy (General Self-Efficacy Scale). Independent physician assessment was used to compare concordance with patients. Results: In all, 207 (CD: 144 and UC: 63) patients, with median age of 39 years, were included, with 42.5% males. Significant proportion of patients reported moderate/severe impairment of disability (30.5%), quality of life (29.4%), productivity (52.4%), anxiety (32.9%) and depression (23.3%). Disease activity and maladaptive coping were independently associated with unfavourable PRO, whereas self-efficacy had a positive effect in multivariate analysis. Physicians could accurately identify the magnitude of PRO impairment in standard clinical settings ( r = 0.59–0.65, P < 0.001). Conclusion: Disease activity and modifiable psychological constructs are associated with unfavorable PRO in patients with IBD. These factors could assist with identifying high-risk patients, many of whom may benefit from targeted interventions to improve health outcomes.

Risk of neutropenia in inflammatory bowel disease patients treated with TNF inhibitors: A single-center, retrospective cohort study

“…[ 1 ] TNFi are generally well tolerated and result in a significant improvement of patients' reported outcomes. [ 2 ] However, a wide range of adverse events have been reported in the literature including hematological, neoplastic, neurological and infectious complications. [ 3 ] One of the most commonly reported side effects are infectious events.…”

Coping Strategies and Inflammatory Bowel Disease: A Narrative Review

“…Many studies examine the relationship between health-related quality of life (HRQoL) and coping strategies, demonstrating a statistically significant correlation between the two variables [ 11 , 12 , 13 , 14 , 15 , 17 , 19 , 20 , 22 , 23 , 24 , 26 , 29 , 30 , 32 , 36 , 37 , 38 , 40 , 41 , 42 , 44 , 45 , 48 , 49 , 55 , 56 , 58 , 61 , 62 , 66 ]. Specifically, maladaptive coping strategies, such as acceptance–resignation, negative religious coping, catastrophizing, passive coping, low acceptance, perceived control, decreased cognitive flexibility, and emotion-focused coping, were all associated with lower HRQoL.…”

“…Chao et al found that both disease activity and maladaptive coping negatively affected HRQoL [ 13 ]. Patients with higher self-efficacy were more likely to report the use of adaptive coping strategies.…”

“…Chao et al [13] The most frequent type of coping among IBD patients was emotion-focused coping. This coping strategy was associated with higher scores for anxiety.…”