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. 2021 Sep;66(9):2916-2924.
doi: 10.1007/s10620-020-06647-y. Epub 2020 Oct 16.

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients

Sara van Gennep  1 , Nanne K H de Boer  2 , Marieke E Gielen  3 , Svend T Rietdijk  4 , Krisztina B Gecse  2 , Cyriel Y Ponsioen  2 , Marjolijn Duijvestein  2 , Geert R D'Haens  2 , Mark Löwenberg  2 , Angela G E M de Boer  5
Affiliations

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients

Sara van Gennep et al. Dig Dis Sci. 2021 Sep.

Abstract

Background: Work-related aspects are important determinants of health for inflammatory bowel disease (IBD) patients.

Aims: We aimed to describe quality of working life (QWL) in IBD patients and to assess variables that are associated with QWL.

Methods: Employed IBD patients of two tertiary and two secondary referral hospitals were included. QWL (range 0-100) was measured using the Quality of Working Life Questionnaire (QWLQ). Work productivity (WP), fatigue, and health-related quality of life (HRQL) were assessed using the Work Productivity and Activity Impairment questionnaire, Multidimensional Fatigue Inventory, and Short Inflammatory Bowel Disease Questionnaire, respectively. Active disease was defined as a score > 4 for the patient-reported Harvey-Bradshaw index in Crohn's disease (CD) or Simple Clinical Colitis Activity Index in ulcerative colitis patients.

Results: In total, 510 IBD patients were included (59% female, 53% CD, mean age 43 (SD 12) years). The mean QWLQ score was 78 (SD 11). The lowest subscore (54 (SD 26)) was observed for "problems due to the health situation": 63% reported fatigue-related problems at work, 48% agreed being hampered at work, 46% had limited confidence in their body, and 48% felt insecure about the future due to their health situation. Intermediate/strong associations were found between QWL and fatigue (r = - 0.543, p < 0.001), HRQL (r = 0.527, p < 0.001), WP loss (r = - 0.453, p < 0.001) and disease activity (r = - 0.331, p < 0.001). Independent predictors of impaired QWL in hierarchical regression analyses were fatigue (B = - 0.204, p < 0.001), WP loss (B = - 0.070, p < 0.001), and impaired HRQL (B = 0.248, p = 0.001).

Conclusions: IBD-related problems at work negatively influence QWL. Fatigue, reduced HRQL, and WP loss were independent predictors of impaired QWL in IBD.

Keywords: Fatigue; Inflammatory bowel disease; Job satisfaction; Quality of life; Quality of working life; Work performance.

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Conflict of interest statement

SG: none; NB: has served as a speaker for AbbVie, Takeda, and MSD. He has served as consultant and principal investigator for Takeda and TEVA Pharma B.V. He has received a (unrestricted) research grant from Dr. Falk, TEVA Pharma B.V, MLDS, and Takeda; MG: none; SR: none; KG: has received consultancy fees and/or speaker’s honoraria from AbbVie, Celltrion, Ferring, Immunic Therapeutics, Janssen, Pfizer, Roche, Sandoz, Samsung Bioepis, Takeda, and Tillotts; CP: has served as a speaker for Takeda, Tillotts, and Roche. He has served as advisor for Takeda, Pliant, and Shire. He has received grant support from Takeda. MD: reports advisory fees from Echo Pharma and Robarts Clinical Trials, Inc., speaker fees from Janssen, Merck & Co., Inc., Pfizer, Takeda and Tillotts Pharma, and nonfinancial support from Dr. Falk. GD: has served as advisor for Abbvie, Ablynx, Amakem, AM Pharma, Avaxia, Biogen, Bristol Meiers Squibb, Boerhinger Ingelheim, Celgene, Celltrion, Cosmo, Covidien, Ferring, DrFalk Pharma, Engene, Galapagos, Gilead, Glaxo Smith Kline, Hospira, Immunic, Johnson and Johnson, Lycera, Medimetrics, Millenium/Takeda, Mitsubishi Pharma, Merck Sharp Dome, Mundipharma, Novonordisk, Pfizer, Prometheus laboratories/Nestle, Protagonist, Receptos, Robarts Clinical Trials, Salix, Sandoz, Setpoint, Shire, Teva, Tigenix, Tillotts, Topivert, Versant and Vifor and received speaker fees from Abbvie, Ferring, Johnson and Johnson, Merck Sharp & Dohme, Mundipharma, Norgine, Pfizer, Shire, Millenium/Takeda, Tillotts and Vifor.; ML: served as speaker and/or principal investigator for Abbvie, Celgene, Covidien, Dr. Falk, Ferring Pharmaceuticals, Gilead, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme, Pfizer, Protagonist therapeutics, Receptos, Takeda, Tillotts, Tramedico and has received research grants from AbbVie, Merck Sharp & Dohme, Achmea healthcare and ZonMW.; AB: none.

Figures

Fig. 1
Fig. 1
Quality of working life in inflammatory bowel disease patients. Mean (SD) total Quality of Working Life Questionnaire (QWLQ) score and subscores of the total IBD cohort
Fig. 2
Fig. 2
Associations between quality of working life and fatigue, IBD-specific health-related quality of life, and work productivity loss. a Association between quality of working life (quality of working life questionnaire (QWLQ) score) and health-related quality of life (short inflammatory bowel disease questionnaire (SIBDQ) score). b Association between quality of working life (QWLQ score) and fatigue (Multidimensional Fatigue Inventory (MFI) score). c Association between quality of working life (QWLQ score) and overall work productivity loss due to IBD in the past week (percentage of work productivity (WP) loss). B unstandardized regression coefficient, r Pearson’s correlation coefficient
Fig. 3
Fig. 3
Quality of working life according to the presence of disease activity, arthralgia and corticosteroid use. Mean (SD) total Quality of Working Life Questionnaire (QWLQ) scores compared between the absence and presence of clinical disease activity (p-HBI or p-SCCAI > 4), arthralgia and corticosteroid use at the time of completing the questionnaire. *p < 0.0001; **p = 0.018
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