1Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
2Department of Pharmacy, Woodlands Health Campus, Singapore
3Department of Pharmacy, Singapore General Hospital, Singapore
© Copyright 2019. Korean Association for the Study of Intestinal Diseases. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
FINANCIAL SUPPORT
The authors received no financial support for the research, authorship, and/or publication of this article.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTION
Conceptualization: Ong WC and Cheen HH. Methodology: Ong WC, Chenn HH, Wee HL, and Lim TG. Formal analysis: Ho YM, Hu W, Lee YY, Gao C, Tan YZ, Cheen HH, and Ong WC. Funding acquisition: Nil. Project administration: Wee HL and Lim TG. Visualization: Ho YM, Hu W, Lee YY, Gao C, Tan YZ, Cheen HH, and Ong WC. Writing-original draft: Ho YM, Hu W, Lee YY, Gao C, Tan YZ, Cheen HH, and Ong WC.
Characteristics | All patients (n=195) | UC (n=103) | CD (n=92) | P-value |
---|---|---|---|---|
Socio-demographics | ||||
Age (yr) | 47.1±15.3 | 51.4±13.6 | 42.3±15.8 | <0.001 |
Sex | 0.200 | |||
Male | 131 (67.2) | 65 (63.1) | 66 (71.7) | |
Female | 64 (32.8) | 38 (36.9) | 26 (28.3) | |
Race | 0.992 | |||
Chinese | 123 (63.1) | 65 (63.1) | 58 (63.0) | |
Malay | 16 (8.2) | 8 (7.8) | 8 (8.7) | |
Indian | 50 (25.6) | 27 (26.2) | 23 (25.0) | |
Eurasian/others | 6 (3.1) | 3 (2.9) | 3 (3.3) | |
Educational level | 0.146 | |||
Non-tertiary | 74 (37.9) | 44 (42.7) | 30 (32.6) | |
Tertiary & above | 121 (62.1) | 59 (57.3) | 62 (67.4) | |
Employment status | 0.880 | |||
Non-employed | 52 (26.7) | 27 (26.2) | 25 (27.2) | |
Employed | 143 (73.3) | 76 (73.8) | 67 (72.8) | |
Monthly income status | 0.658 | |||
Low (<$3,000) | 105 (53.8) | 57 (55.3) | 48 (52.2) | |
High (≥$3,000) | 90 (46.2) | 46 (44.7) | 44 (47.8) | |
Housing type | 0.206 | |||
Public | 158 (81.0) | 80 (77.7) | 78 (84.8) | |
Private | 37 (19.0) | 23 (22.3) | 14 (15.2) | |
Marital status | 0.016 | |||
Single | 52 (26.7) | 18 (17.5) | 34 (36.9) | |
Married | 136 (69.7) | 80 (77.6) | 56 (60.9) | |
Widowed | 5 (2.6) | 4 (3.9) | 1 (1.1) | |
Divorced | 2 (1.0) | 1 (1.0) | 1 (1.1) | |
Smoking status | 0.314 | |||
Non-smoker | 148 (75.9) | 81 (78.7) | 67 (72.8) | |
Smoker | 17 (8.7) | 6 (5.8) | 11 (12.0) | |
Former-smoker | 30 (15.4) | 16 (15.5) | 14 (15.2) | |
CCI | 0.26±0.69 | 0.32±0.66 | 0.18±0.71 | 0.007 |
Clinical characteristics | ||||
Disease duration (yr) | 11.2±9.0 | 12.6±9.6 | 9.6±8.0 | 0.018 |
Disease activity | 0.012 | |||
Remission | 144 (73.8) | 67 (65.1) | 77 (83.7) | |
Mild | 47 (24.1) | 33 (32.0) | 14 (15.2) | |
Moderate | 4 (2.1) | 3 (2.9) | 1 (1.1) | |
Severe | 0 | 0 | 0 | |
CD: disease location | ||||
Ileitis | - | - | 29 (31.5) | |
Ileocolitis | - | - | 39 (42.4) | |
Colitis | - | - | 22 (23.9) | |
Isolated upper GIT | - | - | 2 (2.2) | |
CD: disease behavior | - | |||
Nonstricturing, nonpenetrating | - | - | 52 (56.5) | |
Stricturing | - | - | 15 (16.3) | |
Fistulising | - | - | 12 (13.1) | |
Stricturing & fistulising | - | - | 13 (14.1) | |
CD: perianal disease | - | - | 14 (15.2) | - |
UC: type | - | |||
Proctitis | - | 16 (15.5) | - | |
Proctosigmoiditis | - | 22 (21.4) | - | |
Left-sided colitis | - | 27 (26.2) | - | |
Pancolitis | - | 34 (33.0) | - | |
Pouchitis | - | 4 (3.9) | - | |
Treatment modalities | ||||
5-Aminosalicylates | 148 (75.9) | 100 (97.1) | 48 (52.2) | <0.001 |
Immunomodulators | 92 (47.2) | 24 (23.3) | 68 (73.9) | <0.001 |
Corticosteroids | 31 (15.9) | 15 (14.6) | 16 (17.4) | 0.590 |
Biologics | 44 (22.6) | 7 (6.8) | 37 (40.2) | <0.001 |
Medication adherence | 0.181 | |||
Adherent (MARS ≥20) | 166 (85.1) | 91 (88.3) | 75 (81.5) | |
Non-adherent (MARS <20) | 29 (14.9) | 12 (11.7) | 17 (18.5) | |
Extraintestinal manifestations | 0.059 | |||
Yes | 14 (7.2) | 4 (3.9) | 10 (10.9) | |
No | 181 (92.8) | 99 (96.1) | 82 (89.1) | |
CRP (mg/L)a | 0.852 | |||
≤9.1 | 160 (82.1) | 83 (80.6) | 77 (83.7) | |
>9.1 | 26 (13.3) | 14 (13.6) | 12 (13.0) | |
FC (μg/g)b | 0.036 | |||
≤200 | 67 (34.4) | 39 (37.9) | 28 (30.5) | |
>200 | 74 (37.9) | 30 (29.1) | 44 (47.8) | |
Hospitalizations over 1 yr | 0.55±1.39 | 0.37±1.35 | 0.75±1.41 | 0.001 |
Surgeries over 1 yr | 0.01±0.10 | 0.00±0.00 | 0.02±0.15 | 0.134 |
Statistical significance: aP<0.05, bP<0.01, cP<0.001.
SIBDQ, short IBD questionnaire; SF-36 PCS, physical component summary of Short Form-36; SF-36 MCS, mental component summary of Short Form-36; EQ-5D-3L, EuroQol 5-dimensions 3-levels; VAS, visual analogue scale of EuroQol-5D; MARS, Medication Adherence Report Scale.
Characteristics | All patients (n=195) | UC (n=103) | CD (n=92) | P-value |
---|---|---|---|---|
Socio-demographics | ||||
Age (yr) | 47.1±15.3 | 51.4±13.6 | 42.3±15.8 | <0.001 |
Sex | 0.200 | |||
Male | 131 (67.2) | 65 (63.1) | 66 (71.7) | |
Female | 64 (32.8) | 38 (36.9) | 26 (28.3) | |
Race | 0.992 | |||
Chinese | 123 (63.1) | 65 (63.1) | 58 (63.0) | |
Malay | 16 (8.2) | 8 (7.8) | 8 (8.7) | |
Indian | 50 (25.6) | 27 (26.2) | 23 (25.0) | |
Eurasian/others | 6 (3.1) | 3 (2.9) | 3 (3.3) | |
Educational level | 0.146 | |||
Non-tertiary | 74 (37.9) | 44 (42.7) | 30 (32.6) | |
Tertiary & above | 121 (62.1) | 59 (57.3) | 62 (67.4) | |
Employment status | 0.880 | |||
Non-employed | 52 (26.7) | 27 (26.2) | 25 (27.2) | |
Employed | 143 (73.3) | 76 (73.8) | 67 (72.8) | |
Monthly income status | 0.658 | |||
Low (<$3,000) | 105 (53.8) | 57 (55.3) | 48 (52.2) | |
High (≥$3,000) | 90 (46.2) | 46 (44.7) | 44 (47.8) | |
Housing type | 0.206 | |||
Public | 158 (81.0) | 80 (77.7) | 78 (84.8) | |
Private | 37 (19.0) | 23 (22.3) | 14 (15.2) | |
Marital status | 0.016 | |||
Single | 52 (26.7) | 18 (17.5) | 34 (36.9) | |
Married | 136 (69.7) | 80 (77.6) | 56 (60.9) | |
Widowed | 5 (2.6) | 4 (3.9) | 1 (1.1) | |
Divorced | 2 (1.0) | 1 (1.0) | 1 (1.1) | |
Smoking status | 0.314 | |||
Non-smoker | 148 (75.9) | 81 (78.7) | 67 (72.8) | |
Smoker | 17 (8.7) | 6 (5.8) | 11 (12.0) | |
Former-smoker | 30 (15.4) | 16 (15.5) | 14 (15.2) | |
CCI | 0.26±0.69 | 0.32±0.66 | 0.18±0.71 | 0.007 |
Clinical characteristics | ||||
Disease duration (yr) | 11.2±9.0 | 12.6±9.6 | 9.6±8.0 | 0.018 |
Disease activity | 0.012 | |||
Remission | 144 (73.8) | 67 (65.1) | 77 (83.7) | |
Mild | 47 (24.1) | 33 (32.0) | 14 (15.2) | |
Moderate | 4 (2.1) | 3 (2.9) | 1 (1.1) | |
Severe | 0 | 0 | 0 | |
CD: disease location | ||||
Ileitis | - | - | 29 (31.5) | |
Ileocolitis | - | - | 39 (42.4) | |
Colitis | - | - | 22 (23.9) | |
Isolated upper GIT | - | - | 2 (2.2) | |
CD: disease behavior | - | |||
Nonstricturing, nonpenetrating | - | - | 52 (56.5) | |
Stricturing | - | - | 15 (16.3) | |
Fistulising | - | - | 12 (13.1) | |
Stricturing & fistulising | - | - | 13 (14.1) | |
CD: perianal disease | - | - | 14 (15.2) | - |
UC: type | - | |||
Proctitis | - | 16 (15.5) | - | |
Proctosigmoiditis | - | 22 (21.4) | - | |
Left-sided colitis | - | 27 (26.2) | - | |
Pancolitis | - | 34 (33.0) | - | |
Pouchitis | - | 4 (3.9) | - | |
Treatment modalities | ||||
5-Aminosalicylates | 148 (75.9) | 100 (97.1) | 48 (52.2) | <0.001 |
Immunomodulators | 92 (47.2) | 24 (23.3) | 68 (73.9) | <0.001 |
Corticosteroids | 31 (15.9) | 15 (14.6) | 16 (17.4) | 0.590 |
Biologics | 44 (22.6) | 7 (6.8) | 37 (40.2) | <0.001 |
Medication adherence | 0.181 | |||
Adherent (MARS ≥20) | 166 (85.1) | 91 (88.3) | 75 (81.5) | |
Non-adherent (MARS <20) | 29 (14.9) | 12 (11.7) | 17 (18.5) | |
Extraintestinal manifestations | 0.059 | |||
Yes | 14 (7.2) | 4 (3.9) | 10 (10.9) | |
No | 181 (92.8) | 99 (96.1) | 82 (89.1) | |
CRP (mg/L) |
0.852 | |||
≤9.1 | 160 (82.1) | 83 (80.6) | 77 (83.7) | |
>9.1 | 26 (13.3) | 14 (13.6) | 12 (13.0) | |
FC (μg/g) |
0.036 | |||
≤200 | 67 (34.4) | 39 (37.9) | 28 (30.5) | |
>200 | 74 (37.9) | 30 (29.1) | 44 (47.8) | |
Hospitalizations over 1 yr | 0.55±1.39 | 0.37±1.35 | 0.75±1.41 | 0.001 |
Surgeries over 1 yr | 0.01±0.10 | 0.00±0.00 | 0.02±0.15 | 0.134 |
Measurements of HRQoL | All patients (n=195) | UC (n=103) | CD (n=92) | Mean difference (CD–UC) | P-value |
---|---|---|---|---|---|
SIBDQ scores | |||||
Bowel function | 17.4±3.3 | 17.1±3.4 | 17.7±3.2 | 0.59 | 0.217 |
Emotional status | 16.4±3.7 | 16.8±3.4 | 15.9±4.0 | −0.95 | 0.074 |
Systemic symptoms | 10.2±2.6 | 10.3±2.5 | 10.0±2.8 | −0.36 | 0.339 |
Social performance | 12.0±2.5 | 12.2±2.4 | 11.8±2.7 | −0.42 | 0.251 |
Total SIBDQ score | 55.7±10.4 | 56.5±9.4 | 54.9±11.4 | −1.59 | 0.287 |
SF-36 scores | |||||
Physical functioning | 86.4±17.6 | 85.2±19.2 | 87.8±15.7 | 2.63 | 0.300 |
Role limitations (due to physical health problems) | 74.0±38.0 | 75.5±36.7 | 72.3±39.5 | −3.20 | 0.558 |
Bodily pain | 79.4±23.0 | 79.5±22.3 | 79.3±23.7 | −0.25 | 0.941 |
General health perceptions | 56.5±22.1 | 59.9±22.0 | 52.8±21.8 | −7.13 | 0.024 |
Physical component summary | 74.1±19.2 | 75.0±18.6 | 73.0±20.0 | −1.99 | 0.473 |
Social functioning | 83.2±21.2 | 85.1±20.1 | 81.1±22.2 | −3.96 | 0.193 |
Role limitations (due to emotional problems) | 82.2±32.9 | 84.8±29.8 | 79.3±35.9 | −5.44 | 0.254 |
Vitality or energy level | 57.0±20.3 | 58.7±20.1 | 55.1±20.5 | −3.63 | 0.214 |
General mental health | 73.1±18.6 | 74.6±16.4 | 71.3±20.6 | −3.34 | 0.217 |
Mental component summary | 73.4±19.0 | 75.8±16.0 | 70.6±21.6 | −5.17 | 0.062 |
EQ-5D-3L | |||||
Utility score | 0.83±0.2 | 0.84±0.2 | 0.83±0.2 | −0.01 | 0.759 |
VAS | 71.2±16.5 | 71.9±15.8 | 70.4±17.3 | −1.52 | 0.523 |
Independent variable (reference) | Dependent variable |
||||
---|---|---|---|---|---|
SIBDQ | SF-36 PCS | SF-36 MCS | EQ-5D-3L | VAS | |
Age | 0.134 | 0.060 | 0.281a | −0.001 | −0.272a |
Sex (male) | |||||
Female | −0.465 | −3.462 | −4.025 | −0.050 | −5.087 |
Race (non-Chinese) | |||||
Chinese | 0.092 | 0.731 | 1.464 | 0.017 | −1.951 |
Educational level (secondary/below) | |||||
Tertiary/above | 0.596 | 1.750 | 3.362 | 0.077 | 0.190 |
Employment status (unemployed/students/unable to work) | |||||
Employed | 3.831 | 5.552 | 9.738a | 0.104a | 1.275 |
Monthly income status (<$3,000) | |||||
≥$3,000 | −0.855 | −1.747 | −1.217 | −0.031 | −0.716 |
Housing type (private residence) | |||||
Public residence | −3.230 | −8.070a | −3.238 | −0.018 | −9.207b |
Marital status (single/widowed/divorced) | |||||
Married | 0.877 | −0.324 | 1.631 | 0.036 | 2.224 |
Smoking status (non-/former smoker) | |||||
Smoker | 2.777 | 6.809 | 1.513 | 0.099 | −0.522 |
Charlson Comorbidity Index | −0.491 | −4.531a | −0.585 | 0.016 | 1.248 |
Disease duration | 0.060 | 0.105 | 0.160 | 0.002 | 0.160 |
Disease activity (remission) | |||||
Active disease | −6.293c | −9.409b | −9.743b | −0.051 | −7.254a |
5-Aminosalicylates (no) | |||||
Yes | −0.369 | −1.010 | −1.478 | −0.044 | −0.020 |
Immunomodulators (no) | |||||
Yes | −1.456 | −2.412 | −5.535 | −0.050 | −3.784 |
Corticosteroids (no) | |||||
Yes | −7.392c | −10.390b | −8.827a | −0.053 | −2.428 |
Biologics (no) | |||||
Yes | 0.143 | −2.960 | −5.094 | −0.051 | −2.918 |
Medication adherence (low–MARS <20) | |||||
High–MARS ≥20 | 4.049a | 4.470 | 1.320c | 0.039 | 8.961b |
Extraintestinal manifestation (absent) | |||||
Present | −3.456 | −13.381a | 1.023 | −0.062 | 1.930 |
Hospitalizations over 1 yr | 0.296 | 0.419 | 0.944 | 0.022 | 0.070 |
Measurements of HRQoL | All patients (n=195) | Remission (n=144) | Active (n=51) | Mean difference (active–remission) | P-value |
---|---|---|---|---|---|
SIBDQ scores | |||||
Bowel function | 17.4±3.3 | 18.0±2.9 | 15.8±3.9 | –2.15 | 0.001 |
Emotional status | 16.4±3.7 | 16.7±3.6 | 15.3±3.9 | –1.44 | 0.016 |
Systemic symptoms | 10.2±2.6 | 10.6±2.5 | 9.0±2.7 | –1.56 | <0.001 |
Social performance | 12.0±2.5 | 12.4±2.3 | 10.9±2.9 | –1.55 | 0.001 |
Total SIBDQ score | 55.7±10.4 | 57.4±9.9 | 51.0±10.4 | –6.41 | <0.001 |
SF-36 scores | |||||
Physical functioning | 86.4±17.6 | 86.4±18.5 | 86.7±15.1 | 0.31 | 0.914 |
Role limitations (due to physical health problems) | 74.0±38.0 | 77.8±35.5 | 63.2±42.8 | –14.5 | 0.033 |
Bodily pain | 79.4±23.0 | 81.9±21.1 | 72.4±26.5 | –9.57 | 0.023 |
General health perceptions | 56.5±22.1 | 58.7±21.7 | 50.5±22.3 | –8.19 | 0.023 |
Physical component summary | 74.1±19.2 | 76.2±18.5 | 68.2±20.2 | –8.00 | 0.010 |
Social functioning | 83.2±21.2 | 85.9±20.2 | 75.7±22.1 | −10.11 | 0.003 |
Role limitations (due to emotional problems) | 82.2±32.9 | 85.6±29.7 | 72.5±39.3 | −13.10 | 0.033 |
Vitality or energy level | 57.0±20.3 | 59.6±19.4 | 49.8±21.2 | −9.78 | 0.003 |
General mental health | 73.1±18.6 | 74.4±18.7 | 69.4±17.7 | −4.95 | 0.102 |
Mental component summary | 73.4±19.0 | 75.7±18.7 | 66.9±18.5 | −8.80 | 0.004 |
EQ-5D-3L | |||||
Utility score | 0.83±0.2 | 0.85±0.2 | 0.81±0.2 | –0.04 | 0.310 |
VAS | 71.2±16.5 | 72.6±15.7 | 67.1±18.0 | −5.55 | 0.038 |
Values are presented as mean±SD or number (%). 9 Patients without CRP measured (6 UC, 3 CD). 54 Patients without FC measured (34 UC, 20 CD). CCI, Charlson Comorbidity Index; GIT, GI tract; MARS, Medication Adherence Report Scale; FC, fecal calprotectin.
Values are presented as mean±SD. SIBDQ, short IBD questionnaire; SF-36, Short Form-36 Health Survey; EQ-5D-3L, EuroQol 5-dimensions 3-levels; VAS, visual analogue scale.
Statistical significance: a SIBDQ, short IBD questionnaire; SF-36 PCS, physical component summary of Short Form-36; SF-36 MCS, mental component summary of Short Form-36; EQ-5D-3L, EuroQol 5-dimensions 3-levels; VAS, visual analogue scale of EuroQol-5D; MARS, Medication Adherence Report Scale.
Values are presented as mean±SD. SIBDQ, short IBD questionnaire; SF-36, Short Form-36 Health Survey; EQ-5D-3L, EuroQol 5-dimensions 3-levels; VAS, visual analogue scale.