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Patients with inflammatory bowel disease at risk of sub-optimal outcomes report poorer biopsychosocial functioning than controls: data from two cross-sectional surveys
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posted on 2023-02-10, 03:12 authored by R Orr, David SkvarcDavid Skvarc, Catherine EmersonCatherine Emerson, L Beswick, Lisa OliveLisa Olive, Antonina Mikocka-WalusAntonina Mikocka-WalusInflammatory bowel disease (IBD) is a chronic gastrointestinal disorder. Standard treatment focuses on reducing the inflammatory burden, however, not all patients respond adequately to conventional medical therapy. These patients, referred to as Patients at Risk of Suboptimal Outcomes (PARSO), have not been studied collectively. The present study aimed to understand the biopsychosocial characteristics of patients with IBD at risk of sub-optimal outcomes for targeted multi-disciplinary treatment to encourage optimal outcomes. Two cross-sectional online surveys, including 760 PARSO and 208 control (non-PARSO) participants, were conducted and their data combined. Biopsychosocial factors included quality of life, pain, disease activity, wellbeing, fatigue, stress, social support, and sleep difficulties. Results suggest that active disease, quality of life, stress, social support, sleep difficulties, fatigue, wellbeing, smoking status, IBD subtype, and pain are significantly associated with membership in a subgroup of PARSO. We also used logistic regression to explore variables associated with the total likelihood of PARSO status. Overall, the model predicted the at-risk status to a substantial degree (R 2−2ll = .41, x2 = 401.53, p < .001). Younger age in years, female sex, Crohn’s disease, and greater measured and subjective disease activity significantly increased the likelihood of participants being identified as PARSO; OR CI95% = 0.96 (0.95, 0.97); OR CI95% = 4.46 (2.95, 6.71); OR CI95% = 1.58 (1.05, 2.37); OR CI95% = 3.52 (2.18, 5.69); OR CI95% = 45.99 (14.11, 149.89). A biopsychosocial and personalised approach to IBD care might be necessary to support those at risk of suboptimal outcomes in achieving better long-term wellbeing.
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Journal
Psychology, Health and MedicineLocation
EnglandPublisher DOI
ISSN
1354-8506eISSN
1465-3966Language
EnglishPublication classification
C1 Refereed article in a scholarly journalPublisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTDUsage metrics
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Keywords
biopsychosocial factorsCOMORBIDITYDEPRESSIONHEALTH-CARE UTILIZATIONHOSPITAL ANXIETYInflammatory bowel diseaseLife Sciences & Biomedicinemental healthPatients at Risk of Suboptimal OutcomesPublic, Environmental & Occupational HealthQUALITY-OF-LIFEScience & TechnologyYOUNG-PEOPLEBehavioral and Social ScienceAutoimmune DiseaseDigestive DiseasesPreventionInflammatory Bowel DiseaseCrohn's DiseaseClinical ResearchBasic Behavioral and Social SciencePain ResearchMind and BodyOral and gastrointestinal3 Good Health and Well BeingPsychology not elsewhere classifiedBusiness and Management not elsewhere classified
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