Abstract
Background: Inflammatory Bowel Disease (IBD) is common and rates of paediatric IBD have risen in recent years. In adults, IBD is known to affect health-related quality of life (HRQoL) across multiple domains, including physical symptom burden, social isolation, comorbid mental health conditions, and detrimental impacts on education and work. However, the impact of IBD on children specifically and its relationship to disease characteristics or socioeconomic deprivation is less well understood. Therefore, this present study explored HRQoL within a cohort of children diagnosed with IBD in Aotearoa New Zealand.
Methods: This was a prospective cross-sectional analysis conducted in Aotearoa New Zealand from July 2012 to February 2017 and included children aged 18 years or less with a confirmed diagnosis of IBD. All participants completed the IMPACT-III tool, a self-administered questionnaire that explores HRQoL within four domains (general wellbeing, social functioning, emotional functioning, and body image) and overall; each score ranges from 0-100, with higher scores denoting better HRQoL. Data were also collected on socioeconomic deprivation as assessed using the New Zealand Deprivation Index 2018 (NZDep2018; range 0-10, higher values indicating greater deprivation), disease duration, and disease activity (remission, mild, moderate, severe). A longitudinal subgroup analysis was conducted in participants where 3-month follow-up data were collected.
Results: 91 participants were included, of which 45 (50%) had follow-up assessments at 3-months. Mean age was 13.3 years and 35 (39%) were females. 79 (87%) participants had Crohn’s disease with 9 (10%) and 3 (3%) having ulcerative colitis and IBD unclassified respectively. Total HRQoL scores were low overall (mean 30.8) with mean domain scores ranging from 22 – 39 (Table 1). Children with longer duration of disease reported poorer general wellbeing scores than children with shorter duration (>14 vs < 14 months, mean 26.5 vs 36.3, p = 0.04) and children living in more deprived areas had lower emotional functioning scores than those living in less deprived areas (NZDep2018 >5 vs < 5, mean 33.8 vs 43.4, p = 0.03). No relationships between disease activity, duration or socioeconomic deprivation and HRQoL (total or domain) were identified on multivariable linear regression (all p > 0.05). There were no significant differences in IMPACT-III total or domain scores between baseline and at 3-months follow-up.
Conclusion: IBD is associated with low HRQoL in children within Aotearoa New Zealand, irrespective of disease activity. Longer duration of disease and greater socioeconomic deprivation were linked with subtle reductions in HRQoL within general wellbeing and emotional functioning specifically.
Poster presentation.