Determinants of health-related quality of life in Crohn's disease: A systematic review and meta-analysis

被引:98
|
作者
van der Have, Mike [1 ]
van der Aalst, Karen S. [1 ]
Kaptein, Ad A. [2 ]
Leenders, Max [1 ]
Siersema, Peter D. [1 ]
Oldenburg, Bas [1 ]
Fidder, Herma H. [1 ]
机构
[1] Univ Med Ctr Utrecht, Dept Gastroenterol & Hepatol, NL-3500 GA Utrecht, Netherlands
[2] Leiden Univ, Med Ctr, Sect Med Psychol, NL-2300 RA Leiden, Netherlands
来源
JOURNAL OF CROHNS & COLITIS | 2014年 / 8卷 / 02期
关键词
Crohn's disease; Health-related quality of life; Patient-reported outcomes; Determinants; Systematic review; INFLAMMATORY-BOWEL-DISEASE; MAINTENANCE THERAPY; ULCERATIVE-COLITIS; WORK DISABILITY; GENERAL HEALTH; CARE; PREDICTORS; UNEMPLOYMENT; PROGNOSIS; SEVERITY;
D O I
10.1016/j.crohns.2013.04.007
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and aims: Understanding the determinants of Crohn's disease (CD) patients' health-related quality of life (HRQOL) may facilitate interventions that improve HRQOL. Therefore, we systematically assessed determinants of HRQOL in adult CD patients. Methods: The databases PubMed, EMBASE, the Cochrane Library, PsycINFO and CINAHL were searched for English abstracts, related to socio-demographic, psychological, clinical and treatment-related determinants of HRQOL in CD disease. Two independent reviewers extracted study characteristics and assessed the methodological quality according the criteria of Hayden et al. The main outcome was the number of studies showing a statistically significant association between the above-mentioned determinants and HRQOL. A meta-analysis was performed to quantify the relationship between disease activity and HRQOL. Results: Of the 2060 articles identified, 29 eligible studies were included. The majority of studies were cross-sectional and had a moderate to high quality. Data on psychological determinants were scarce. Work disability, increased disease activity, number of relapses, corticosteroid treatment and hospitalization rate were significantly associated with a lower HRQOL in the majority of included studies. Biological treatment positively influenced HRQOL. The pooled data on the association between disease activity and HRQOL resulted in a weighed mean correlation coefficient of -0.61 (CI -0.65 to -0.57). Conclusions: HRQOL of adult CD patients is consistently determined by markers of active disease, including work disability, increased disease activity, number of relapses, biological treatment and hospitalization rate. As disease activity contributed to only 37% of HRQOL, there remains a need for additional, possibly modifiable, determinants. These determinants may refine possibilities to improve HRQOL. (C) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:93 / 106
页数:14
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