Assessment of the influence of disease activity on the quality of life of patients with inflammatory bowel disease using a short questionnaire

Objectives: Inflammatory bowel disease impairs health-related quality of life. Therefore, it is very important to develop adequate instruments to measure the disease impact, but these instruments need to be practical as well as accurate. Our aim was to determine whether a short questionnaire obtained from the reduction of the 36-item version of the inflammatory bowel disease questionnaire (IBDQ-36) accurately reflects the impact of clinical and endoscopic activity on health-related quality of life. Methods: To this purpose the original IBDQ-36 and a reduced version, composed of only 9 items (IBDQ-9), were administered to 68 patients with inflammatory bowel disease. Disease activity was established by standard clinical activity indices (Rachmilewitz for ulcerative colitis (UC) and Harvey-Bradshaw for Crohn's disease (CD)) and by information gathered at colonoscopy. Results: In UC patients the Spearman's correlation coefficients between IBDQ-9 and clinical and colonoscopic indices were statistically significant (-0.67 and -0.70, respectively, p<0.01) and similar to those obtained with IBDQ-36 (-0.61 and -0.67). In CD patients IBDQ-9 also correlated well with the clinical index (-0.59, p<0.05) but less with the colonoscopic index (-0.30, p=0.1). In CD patients, the correlation of the IBDQ-36 with clinical and colonoscopic indices gave similar results to the IBDQ-9 (-0.58 and -0.21, respectively). The IBDQ-9 power to discriminate between clinical relapse and remission was statistically significant (p<0.01) both for UC (55 (48-57) vs 69 (63-75) and CD (58 (51-63) vs 69 (64-83)) patients. Similar results were obtained for conoloscopic indices of endoscopic relapse and remission (56 (52-65) vs 70 (66-77) in UC and 58 (52-63) vs 68 (62-73) in CD). Conclusions: Quality of life impairment produced by relapses of inflammatory bowel disease can be reliably assessed with a short questionnaire, with considerable savings in time and expense.