Association between disease activity and quality of life in ulcerative colitis: Results from the CRONICA‐UC study

• Published in: Journal of gastroenterology and hepatology Vol. 32; no. 11; pp. 1818 - 1824
• Main Authors: Panés, Julián, Domènech, Eugeni, Aguas Peris, Marian, Nos, Pilar, Riestra, Sabino, Juliá de Páramo, Berta, Cea‐Calvo, Luis, Romero, Cristina, Marín‐Jiménez, Ignacio
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.11.2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Colitis, Ulcerative - psychology; Colon; disease activity; Female; Follow-Up Studies; health‐related quality of life; Humans; Inflammatory bowel disease; Internet; Male; Middle Aged; Patients; Psychometrics; Quality of Life; questionnaire; Remission; Severity of Illness Index; Standard deviation; Surveys and Questionnaires; symptoms; Time Factors; Ulcerative colitis; Young Adult; symptoms; disease activity; questionnaire; health-related quality of life; ulcerative colitis
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.13795

Background and Aim In ulcerative colitis (UC), the main goals of treatment are to control disease activity and normalize health‐related quality of life (HRQoL). In this study, we explored the relationship between disease activity (measured using the Simple Clinical Colitis Activity Index [SCCAI]) and patient HRQoL (measured using the EuroQoL [EQ]‐5D‐5L). Methods A total of 199 patients with UC were followed for 6 months. At months 3 and 6, patients completed an online SCCAI. Within 2 days of completing the SCCAI, patients completed an at‐clinic EQ‐5D‐5L questionnaire and the treating gastroenterologist completed the SCCAI. Results A consistent and approximately linear relationship was identified between patient HRQoL and patient‐completed and physician‐completed SCCAIs. A lower SCCAI score corresponded to a higher EQ‐5D‐5L index value. Correlation between EQ‐5D‐5L index values and patient‐completed online SCCAIs was moderate (ρ −0.49; P < 0.001) and similar to that between EQ‐5D‐5L index values and physician‐completed SCCAIs (ρ −0.53; P < 0.001). A decrease in the EQ‐5D‐5L index was already observed at an SCCAI score of 2, commonly regarded as remission. A 1‐point increase in the patient SCCAI corresponded to an average change of −0.027 (standard deviation, −0.032 to −0.022) in the EQ‐5D‐5L index, whereas a 1‐point increase in the physician SCCAI corresponded to an average change of −0.030 (standard deviation, −0.036 to −0.025). Conclusions Health‐related quality of life measured using the EQ‐5D‐5L questionnaire is proportionally related to disease activity in patients with UC. In line with the treat‐to‐target objective in UC, complete control of all symptoms is required to achieve optimal improvement in patient HRQoL.