Abstract
Introduction. The quality of life (QoL) of Crohn's Disease (CD) patients is a recognized endpoint in interventional studies. However, less is known about the QoL in cohorts of patients in all stages of the disease. We aimed, for the first time, to determine the QoL of Israeli CD patients in a cross-sectional observational study, and relate this to comparable CD cohorts from other countries. Methods. The cohort comprised adult (age 18 years and over) patients presenting for follow-up in the IBD out-patient clinics in our hospitals. Patients
were assessed for their current clinical status, including the Harvey-Bradshaw Index of disease severity (HBI), and they completed the self-administered generic SF-36 QoL questionnaire. These 36 questions yield an 8-scale profile composed of the Physical Health Measure [incorporates scales of Physical Functioning (PF), Role-Physical (RP), Bodily Pain (BP) and General Health (GH)] and the Mental Health Measure [Vitality (VT), Social Functioning (SF), Role-Emotional (RE) and Mental Health (MH)]. Scales run from 0 through 100. Values
in healthy populations in 5 countries (Israel, USA, UK, Australia and Spain) were accessed from published articles. Results. The cohort comprised 148 men (40.4%) and 219 women (59.6%), respectively mean age ± SD: 35.7 ± 13.4 and 40.3 ± 15.1 years (p < 0.01), and disease duration: 10.5 ± 8.8 and 12.5 ± 9.4 years (p = ns). SF-36 scores for the 8 scales in the healthy populations ("norm") ranged from 85% (best) to 56% (worst), but were lower in Israel compared to the USA, UK, Spain and Australia. However, the SF-36 scores in all
5 countries showed general agreement of variations in magnitude across the spectrum of scales, being lowest for GH (72 to 56%) and VT (67 to 57%), and highest for PF, RP, SF and RE. SF-36 scores of Israeli CD patients were in the 50th to 35th percentiles relative to the Israeli norm, but were 10% lower when compared with the USA norm; values for RP (32nd percentile), GH (22nd percentile) and RE (26th percentile) were the lowest compared to USA norm. Israeli CD patients had lower SF-36 scores in 5 of 8 scales relative to French
and Spanish CD cohorts. SF-36 scores varied significantly by the HBI, with moderate and severe disease having much lower scores in all the scales (p < 0.001, see Figure). Furthermore,Israeli patients' SF-36 scores were significantly lower when the time to diagnosis exceeded 1 year, when the disease was of longer duration (cut-off 9 years), and when the patient cohort was older (cut-off 40 years) at time of diagnosis. Conclusions. We have shown that SF-36 scores in Israeli CD patients are low, must be interpreted in relationship to population
norms, and are impacted by HBI disease severity, duration of illness, patient age at onset, and delayed diagnosis. These are important clinical considerations for the treating gastroenterologist.
were assessed for their current clinical status, including the Harvey-Bradshaw Index of disease severity (HBI), and they completed the self-administered generic SF-36 QoL questionnaire. These 36 questions yield an 8-scale profile composed of the Physical Health Measure [incorporates scales of Physical Functioning (PF), Role-Physical (RP), Bodily Pain (BP) and General Health (GH)] and the Mental Health Measure [Vitality (VT), Social Functioning (SF), Role-Emotional (RE) and Mental Health (MH)]. Scales run from 0 through 100. Values
in healthy populations in 5 countries (Israel, USA, UK, Australia and Spain) were accessed from published articles. Results. The cohort comprised 148 men (40.4%) and 219 women (59.6%), respectively mean age ± SD: 35.7 ± 13.4 and 40.3 ± 15.1 years (p < 0.01), and disease duration: 10.5 ± 8.8 and 12.5 ± 9.4 years (p = ns). SF-36 scores for the 8 scales in the healthy populations ("norm") ranged from 85% (best) to 56% (worst), but were lower in Israel compared to the USA, UK, Spain and Australia. However, the SF-36 scores in all
5 countries showed general agreement of variations in magnitude across the spectrum of scales, being lowest for GH (72 to 56%) and VT (67 to 57%), and highest for PF, RP, SF and RE. SF-36 scores of Israeli CD patients were in the 50th to 35th percentiles relative to the Israeli norm, but were 10% lower when compared with the USA norm; values for RP (32nd percentile), GH (22nd percentile) and RE (26th percentile) were the lowest compared to USA norm. Israeli CD patients had lower SF-36 scores in 5 of 8 scales relative to French
and Spanish CD cohorts. SF-36 scores varied significantly by the HBI, with moderate and severe disease having much lower scores in all the scales (p < 0.001, see Figure). Furthermore,Israeli patients' SF-36 scores were significantly lower when the time to diagnosis exceeded 1 year, when the disease was of longer duration (cut-off 9 years), and when the patient cohort was older (cut-off 40 years) at time of diagnosis. Conclusions. We have shown that SF-36 scores in Israeli CD patients are low, must be interpreted in relationship to population
norms, and are impacted by HBI disease severity, duration of illness, patient age at onset, and delayed diagnosis. These are important clinical considerations for the treating gastroenterologist.
| Original language | English |
|---|---|
| Pages (from-to) | S843-S843 |
| Journal | Gastroenterology |
| Volume | 148 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2015 |