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. 2023 Nov 10;15(2):130-136.
doi: 10.1136/flgastro-2023-102428. eCollection 2024 Mar.

Inflammatory Bowel Disease Disability Index is a valid and reliable measure of disability in an English-speaking hospital practice and predicts long-term requirement for treatment escalation

Darragh Storan  1 , Edel McDermott  1 , Jenny Moloney  2 , Lisa Keenan  3 , Roisin Stack  1   2 , Juliette Sheridan  1 , Glen Doherty  1 , Garret Cullen  1 , Louise McHugh  3 , Hugh E Mulcahy  1
Affiliations

Inflammatory Bowel Disease Disability Index is a valid and reliable measure of disability in an English-speaking hospital practice and predicts long-term requirement for treatment escalation

Darragh Storan et al. Frontline Gastroenterol. .

Abstract

Objective: The Inflammatory Bowel Disease Disability Index (IBD-DI) was developed according to WHO standards and has been validated in population-based cohorts. However, there are limited data on its relationship to various psychosocial and economic variables or its relevance to hospital clinical practice. The study aims were to determine the validity and reliability of the IBD-DI in an English-speaking hospital out-patient population and to evaluate its association with short and long-term disease activity.

Design/methods: 329 subjects were enrolled in a cross-sectional and longitudinal study assessing the IBD-DI and a range of quality of life, work impairment, depression, anxiety, body image, interpersonal, self-esteem, disease activity, symptom scoring scales in addition to long-term outcome.

Results: The IBD-DI had adequate structure, was internally consistent and demonstrated convergent and predictive validity and was reliable in test-retest study. Disability was related to female sex (p=0.002), antidepressant use (p<0.001), steroid use (p<0.001) and disease activity (p<0.001). Higher IBD-DI scores were associated with long-term disease activity and need for treatment escalation in univariate (p<0.001) and multivariate (p=0.002) analyses.

Conclusion: The IBD-DI is a valid and reliable measure of disability in English-speaking hospital populations and predicts long-term requirement for treatment escalation.

Keywords: IBD clinical; inflammatory bowel disease.

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Conflict of interest statement

Competing interests: DS is a UCD Newman Fellow sponsored by Boston Scientific. GD has served as a speaker, a consultant and an advisory board member for Abbvie, MSD, Pfizer, Amgen, Janssen, Shire, Takeda and Tillotts, and has received research funding from Abbvie, MSD and Pfizer. HM has served as a speaker for Dr Falk Pharma, MSD, Ferring, Boston Scientific, Tillotts and Janssen, serves as a consultant for Boston Scientific and has received funding from Pfizer, Dr Falk and Abbvie.

Figures

Figure 1
Figure 1
Frequency of IBD-DI scores in (A) Crohn’s disease and (B) ulcerative colitis subjects. (C) Percentage of 329 subjects answering each of 14 IBD-DI questions 1–5. (D) Scree plot of eigenvalues from principal component analysis. IBD-DI, Inflammatory Bowel Disease Disability Index.
Figure 2
Figure 2
Relationship between disability, disease activity and psychosocial variables in 329 IBD subjects. (A) Box and whisker plot of physicians’ baseline disease activity assessment and disability. (B) Spearman correlations between disability and quality of life, (C) percent overall health-related work impairment, (D) depression and (E) sexual dissatisfaction. IBD-DI, Inflammatory Bowel Disease Disability Index.
Figure 3
Figure 3
Cumulative risk of short-term disease activity requiring treatment escalation (in the first follow-up year) associated with (A) baseline disease activity and (B) baseline disability (IBD-DI). Cumulative risk of long-term disease activity requiring treatment escalation (after 1 year) associated with (C) baseline disease activity and (D) baseline IBD-DI. IBD-DI, Inflammatory Bowel Disease Disability Index.
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