Disease activity in ulcerative colitis causes significant impairment in a patient’s capacity to work, clinicians at a Victorian centre have shown.

A study of patient-reported outcomes in 81 people with ulcerative colitis or Crohn’s disease attending gastroenterology clinics at Melbourne’s The Austin Hospital found that 26% of patients had symptoms of depression and 46% had anxiety.

A moderate-to-strong correlation was found between disease activity and depression in people who had ulcerative colitis.

Only a weak association was seen in Crohn’s disease, which might be because patients already had high levels of distress while in remission, the study authors suggested.

For patients with ulcerative colitis, disease activity correlated with overall work impairment due to health, health-related impairment while working, and percentage of activity impaired due to health.

Dr Jackson

Led by Dr Belinda Jackson, consultant gastroenterologist at The Austin Hospital, the study authors said their findings suggested it was important not to overlook patient-reported outcomes in the treat-to-target era when the focus is often on surrogate outcomes of inflammation such as CRP or fecal calprotectin.

Patient-reported outcomes could be measured by surveys to quantify anxiety and depression, work productivity measures, patient satisfaction, fatigue, quality of life and disability, they wrote in the Internal Medicine Journal.

“Monitoring patients’ ability to function and work, rather than minimizing disease activity alone, should become a routine part of IBD care,” they concluded.

“Further work is required to discern the interaction between patient-reported outcomes over and above disease activity in order to find interventions that improve patients’ ability to function,” they added.