Cross-Sectional Analysis of Quality of Life in Pediatric Patients with Inflammatory Bowel Disease in British Columbia, Canada.

OBJECTIVES: To evaluate Quality of Life (QoL) in a large cohort of pediatric patients with Inflammatory Bowel Disease (IBD) and to identify the clinical factors that influence QoL.

STUDY DESIGN: This cross-sectional study analyzes a quality improvement initiative in 351 pediatric patients with IBD in British Columbia, Canada using the self-reported PedsQL 4.0 generic scale. The questionnaire was completed at outpatient clinic and biologic infusion appointments. Statistical analysis included the t-test, ANOVA and multilinear regressions to evaluate the relationships between clinical factors and QoL.

RESULTS: Mean (SE) QoL scores (79.95 (0.84)) fell between previously described healthy and chronically ill populations. Disease activity was the most significant predictor of QoL, with patients in remission scoring similar (84.42 (0.87)) to well established healthy norms, and those with moderately or severely active disease having some of the lowest published PedsQL scores (63.13 (3.27), lower than most other chronic pediatric conditions. 25 patients with moderately or severely active disease at the time of survey completion had follow-up surveys identified one year later and had a significant improvement of both their disease activity (P < .005) and their PedsQL scores (follow-up survey mean 76.13 (3.11)). Additional clinical factors independently associated with poor QoL were school non-attendance (15.5% decrease in QoL, p<0.001), immune-modulator selection (Methotrexate conferring a 9.5% lower mean QoL score than Azathioprine, p=0.005) and female sex, (p=0.031).

CONCLUSION: Pediatric patients with IBD experience a QoL significantly impacted by multiple clinical factors including current severity of IBD symptoms.