Previous experience and quiality of life in patients with inflammatory bowel disease during relapse.

BACKGROUND: inflammatory bowel disease (IBD) permanently impairs patients' perception of their health-related quality of life(HRQoL). A variable that may influence HRQoL perception is the capacity to cope with the disease, which may be influenced by previous experiences. In this respect, it is unknown whether past experience with previous relapses of IBD influences HRQoL perception.

OBJECTIVE: the present study aims to determine whether HR-QoL at disease onset differs from that in repeated relapses of the disease.

PATIENTS AND METHOD: 120 patients with clinically active IBD according to the Rachmilewitz index for the 57 patients with ulcerative colitis (UC) or the Harvey-Bradshaw index for the 63 with Crohn's Disease (CD). Patients were divided into two different groups depending on whether the outbreak was at onset of the disease (42 patients) or corresponded to the fourth or more relapses(78 patients). Each patient completed three HRQoL questionnaires: two generic (EuroQol and the Psychological General Well-Being Index -PGWBI-) and one specific (Inflammatory Bowel Disease Questionnaire -IBDQ-).

RESULTS: patient characteristics (age, sex, smoking habit, activity index, hospital admission) were similar among the 4 groups of patients included. Time of evolution since diagnosis was significantly longer in the prolonged disease groups (median [percentiles 25-75]: (40 124-481 and 68 [36-120] for UC and CD, respectively) compared with the debut groups (1 [1-21 and 2 [1-2] for UC and CD, respectively) (p<0.001). IBDQ score did not differ between debut and prolonged disease groups either in UC or CD(4.0 vs 4.1 in CC and 4.3 us 4.3 in CD, p=ns). Absence of differences was also observed with the PGWBI (89 vs 78 in UC and 80.5 us 83 in CD, p=ns) and the EuroQol (tariff of 0.64 vs 0.57 in UC and 0.60 us 0.68 in CD, p=ns).

CONCLUSIONS: accumulated previous experience with IBD relapses does not seem to significantly affect HRQoL perception during relapses of the disease.