Fatigue interference with daily living among patients with inflammatory bowel disease
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The purpose of the study was to examine fatigue interference with daily living in patients with inflammatory bowel disease (IBD) and to explore relationships between severe fatigue interference and socio-demographic and clinical variables, including use of complementary and alternative medicine (CAM).
Data were collected using self-report questionnaires from adult IBD outpatients. Fatigue interference was assessed with the 5-item Fatigue Severity Scale, and scores ≥5 were defined as severe fatigue interference. CAM use was assessed with the International CAM Questionnaire. Multivariate logistic regression analysis was used to examine associations between severe fatigue interference and socio-demographic factors, clinical factors, and CAM use.
In total, 428 patients had evaluable questionnaires (response rate 93 %). Severe fatigue interference was reported by 39 % of the total sample. Patients with Crohn’s disease (CD) (n = 238) were more likely than patients with ulcerative colitis (UC) (n = 190) to report severe fatigue interference (43 and 33 %, respectively, p = 0.003). In addition, patients reporting severe fatigue interference were more likely to have active disease than patients without severe fatigue interference (p < 0.001 for both diagnoses). Patients with inactive disease had scores comparable to the general population. Factors independently associated with severe fatigue interference in UC included disease activity and CAM use, while in CD they included disease activity and current smoking.
Severe fatigue interference is common among IBD patients with active disease. Among patients with UC, but not CD, CAM use was associated with severe fatigue interference. The relationship between fatigue interference and personal factors should be considered further in subsequent studies.
KeywordsFatigue Inflammatory bowel disease Ulcerative colitis Crohn’s disease Complementary and alternative medicine
The authors thank the following persons for including patients in the study: Elisabeth Finnes Strom, Turid Bua, Gunnhild Seim, and Elisabeth Haugen, Oslo University Hospital, Oslo; Ellen Vogt, Diakonhjemmet Hospital, Oslo; Magne Henriksen, Kjersti Eek and Elisabeth Hansen, Ostfold Hospital Trust, Fredrikstad, Sarpsborg and Moss; Roald Torp and Øystein Hovde, Innlandet Hospital Trust, Hamar and Gjovik; Trygve Hausken, Haukeland University Hospital, Bergen; Ole Hoie, Jenny Nornes and Heidi Solhaug, Southern Hospital Trust, Arendal and Kristiansand; Nina Lindheim, Telemark Hospital Trust, Skien; Venke Ekornseter Knutsen, Health Fonna, Haugesund; and Inger Johanne Bo, Stavanger University Hospital. We also thank Marte Lie Hoivik for reviewing the manuscript for intellectual content, Milada Cvancarova for statistical guidance, and Ferring Pharmaceuticals for their practical and financial help with preparation of the study.
Conflict of interest
The preparation of this study was funded in part by Ferring Pharmaceuticals. The authors have no competing interests to report.
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