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

Ioannis Varbobitis; Georgios Kokkotis; Michael Gizis; Nikoletta Perlepe; Efrosini Laoudi; Maria Bletsa; Despoina Bekiari; Ioannis Koutsounas; Georgios Kounadis; Vassileios Xourafas; Stilliani Lagou; George Kolios; Ioannis Papakonstantinou; Giorgos Bamias

doi:10.1093/ibd/izaa201

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

Inflamm Bowel Dis. 2021 May 17;27(6):826-835. doi: 10.1093/ibd/izaa201.

Affiliations

¹ Department of Gastroenterology, Nottingham Digestive Diseases Centre, Nottingham University Hospitals NHS, Nottingham, UK.
² GI Unit, 3rd Department of Internal Medicine, National & Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece.
³ Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
⁴ Second Department of Surgery, National and Kapodistrian University of Athens, Medical School, Aretaieion University Hospital, Athens, Greece.

PMID: 32766770
DOI: 10.1093/ibd/izaa201

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.

Keywords: IBD; IBD-F; fatigue; quality of life; questionnaires.

MeSH terms

Adult
Chronic Disease
Crohn Disease* / complications
Fatigue* / diagnosis
Fatigue* / etiology
Female
Humans
Male
Quality of Life
Reproducibility of Results
Self-Assessment*
Severity of Illness Index
Surveys and Questionnaires