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P163 Assessment of the Inflammatory Bowel Disease Fatigue Patient Self-Assessment Scale in a Greek population of outpatients with IBD

I. Varbobitis, S. I. Siakavellas*, C. Kosmidis, I. Koutsounas, G. Bamias

Laikon Hospital, Academic Dpt. of Gastroenterology, Athens, Greece

Background

Fatigue is a common manifestation of IBD that has been found to correlate with poor quality of life of patients. There is a current trend to incorporate fatigue as a patient-reported outcome (PRO) into clinical decision making. The Inflammatory Bowel Disease-Fatigue (IBD-F) patient self-assessment scale is a novel tool that estimates both the level of fatigue (SCORE 1) and the effect of IBD-related fatigue into everyday activities (SCORE 2). Our Aim was to validate and investigate the performance of the IBD-F scale in a Greek population of IBD patients.

Methods

The original English version of the IBD-F patient self-assessment scale was subjected to formal procedures for translation and validation. IBD outpatients who are followed at the Inflammatory Bowel Disease outpatient service of ‘Laiko’ Hospital, a tertiary university hospital in Athens, Greece, participated in a pilot study. Patients with acute exacerbation of IBD or comorbidities were excluded. Patients were given the Greek IBD-F questionnaires and were asked to fill them at home and return them. Scores of the IBD-F questionnaire were correlated with demographic data (sex, age, body mass index [BMI], smoking status, and working status), disease characteristics (type/duration of IBD, type/duration of treatment, and previous operations), and biochemical parameters.

Results

In total, 31 patients (18 males, mean age 33 yr old) completed and returned their questionnaires. On a scale of 0 (no fatigue) to 4 (severe fatigue), the median SCORE 1 for patients in this cohort was 1.6 (1 denoting mild and 2 moderate fatigue). Regarding SCORE 2 (range 0–4), median average score was 0.7, which indicates that fatigue affected the patients’ daily activities none (score 0) or only some of the time (score 1). There was no difference between Crohn’s disease (CD) and ulcerative colitis (UC) in our cohort. In CD patients, there was a significant association between Harvey–Bradshaw Index (HBI) and SCORE 1 (p = 0.019) and a trend towards association between HBI and SCORE 2 (P = 0.077). For UC patients, no similar association was demonstrated for SCCAI, but SCORE 2 was marginally associated with Fe levels (p = 0.055), although not with Hb. Finally, there was a significant association between treatment with anti-tumour necrosis factor (TNF) and SCORE 2 (p = 0.0110) and a trend towards significance with SCORE 1 (p = 0.073).

Conclusion

Fatigue is a common complaint amongst IBD patients. Fatigue may be associated with higher disease activity in CD and with iron deficiency in UC. The strong association with the use of anti-tumour necrosis factor (TNF) treatment may either reflect more severe disease in those patients or represent a treatment-induced effect.