The IBD-F Patient Self-Assessment Scale Accurately Depicts the Level of Fatigue and Predicts a Negative Effect on the Quality of Life of Patients With IBD in Clinical Remission

Abstract

Background Fatigue is highly prevalent among patients with inflammatory bowel disease (IBD) and may have an unfavorable impact on quality of life (QoL). The IBD-Fatigue scale (with components SCORE1 and SCORE2) is a recently developed disease-specific questionnaire. We sought to validate a Greek version of IBD-F and use it to assess the severity and characteristics of fatigue and its effect on QoL in our study population. Methods The IBD-F scale was validated and used to obtain fatigue-related data from patients with IBD attending a tertiary care hospital. Correlations with other fatigue and QoL instruments were performed. Results The Greek IBD-F showed high internal consistency and test-retest reliability (Cronbach’s alpha = 0.901/0.966 and intraclass correlation coefficient = 0.876/0.895 for SCORE1/SCORE2, respectively). A SCORE1 >7.5 suggested “significant” fatigue. In a cohort of 157 patients (mean age = 35.8 y; male patients = 52.2%; patients with Crohn disease = 65.6%), both SCORE1 and SCORE2 were significantly associated with Crohn disease (odds ratio [OR] = 4.17; 95% confidence interval [CI], 2.05-8.47; b = 8.5; 95% CI, 2.8-14.1, respectively), female sex (OR = 7.27; 95% CI, 3.19-16.6; b = 15.3; 95% CI, 9-21.6), and Harvey-Bradshaw Index/Simple Clinical Colitis Activity Index score (OR = 1.22; 95% CI, 1.06-1.39; b = 1.8; 95% CI, 0.9-2.8). A SCORE1 >7.5 was present in 46% of patients in remission, and 82% of patients with a baseline SCORE1 >7.5 remained fatigued at serial measurements. The SCORE1 was significantly associated with impaired QoL (P < 0.001). Conclusions The validated IBD-F scale is a useful and applicable instrument for use in the IBD population. A large proportion of patients have significant fatigue, which is maintained longitudinally, independent of inflammatory activity. Fatigue impairs QoL, thus necessitating interventions that may lead to its amelioration in the IBD population.

Prevalence of Fatigue and Unrecognized Depression in Patients with Inflammatory Bowel Disease in Remission under Immunosuppressants and Biologicals

“…The current study reported abnormal physical fatigue (SFQ ≥ 18) in 51% of IBD patients in well-defined clinical and biochemical remission. These results are comparable with studies from Villoria et al, where 54% of IBD patients in remission were fatigued (based on the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F)), and Varbobitis et al, with a fatigue rate of 46% (IBD-Fatigue scale) [ 30 , 31 ]. In the studies by Williet et al (FACIT-F), Bager et al (Multidimensional Fatigue Inventory (MFI)) and Graff et al (MFI) the prevalence of fatigue was slightly lower: around 26–30% of IBD patients in remission [ 29 , 32 , 33 ].…”

“…In line with the available literature, female sex was one of the main risk factors for fatigue, but a good explanation for this observation has not yet been found [30][31][32]34,35]. The effect of TNF-inhibitors on fatigue is still undetermined.…”

Patient-Reported Impact of Symptoms in Crohn's Disease

“…Previous studies have investigated the wide spectrum of symptoms, such as lack of energy and poor relationships with food, that affect the physical, emotional, and social realms of CD patient QoL ( 8 , 9 ). A large online cohort study in 2011–2012 conducted through the Crohn's & Colitis Foundation of America reported more depression, anxiety, fatigue, sleep disturbance, pain interference, and social dissatisfaction in a cohort of patients with IBD (∼63% with CD) compared with the general population ( 10 ).…”

Chronic Fatigue Syndrome in Patients with Deteriorated Iron Metabolism

“…The Inflammatory Bowel Disease Fatigue Scale (IBD-F) consists of three sections. Section one measures the severity and frequency of fatigue, section two measures the experience and impact of fatigue on the individual’s life, and section three contains unscored open-ended questions about possible factors contributing to fatigue [ 37 ]. The first two sections are scored on a Likert scale from 0 to 4, and possible total scores are 0–20 in section one and 0–120 in section two.…”