Quality of life in inflammatory bowel disease: a systematic review and meta-analyses—part I
Open accessAbstract
Background: Quality of life (QoL) is commonly assessed in inflammatory bowel disease (IBD); the relationship of QoL within IBD states and relative to others has not been comprehensively evaluated. This systematic review, published across 2 papers, evaluates 5 key QoL comparisons. Part I, presented here, examines between-disease comparisons: (1) IBD/healthy(general) population and (2) IBD/other medically ill groups. Part II examines within-disease comparisons: (3) active/inactive disease, (4) ulcerative colitis/Crohn's disease, and (5) change over time. Outcomes using generic vs IBD-specific QoL measures were also examined. Methods: Adult and pediatric studies were identified through systematic searches of 7 databases from the 1940s (where available) to October 2015. Results: Of 6173 abstracts identified, 466 were selected for final review based on controlled design and validated measurement; 30 unique studies (23 adult, 7 pediatric) addressed the between-disease comparisons. The pooled mean QoL scores were (1) lower in adult and pediatric IBD samples compared with healthy controls (n = 19), and for both mental and physical QoL, where measured; and (2) higher but not significant for those with IBD compared with various medically ill controls (n = 15). Findings were consistent across IBD-specific and generic QoL measures. Study quality was generally low to moderate. The most common measures of QoL were the disease-specific Inflammatory Bowel Disease Questionnaire and generic SF-36 (adults), and the generic PedsQL (children). Conclusions: There was robust confirmation that QoL for individuals with IBD was poorer than for healthy individuals, for both adults and children. QoL in IBD may be better relative to some other gastrointestinal (GI) and non-GI medical conditions for children.
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People with IBD experience a consistently poor quality of life both during disease flare-ups and remission.
“Our meta-analyses found that people with IBD experience a consistently poor quality of life (QoL) both during disease flare-ups and remission.6 7”
From Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): protocol for a feasibility trial of the ACTforIBD programme (2022) · cites this paper as [7]
The Results (p. 1) and Discussion (p. 9) report consistently poorer quality of life among people with IBD than among healthy controls. But this Part I paper does not establish that quality of life is poor during both flare-ups and remission: its introduction (p. 1) assigns the active-versus-inactive disease comparison to Part II. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPeople with IBD commonly experience symptoms of depression and anxiety and poorer HRQoL compared with the general population.
“Compared with the general population, people diagnosed with inflammatory bowel disease (IBD) commonly experience symptoms of depression and anxiety (often collectively called distress) and poorer health-related quality of life (HRQoL).1,2”
From Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress. (2024) · cites this paper as [1]
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“The incurability, unpredictability and severity of IBD symptoms provide lifelong challenges for patients, contributing to a significant psychosocial burden, impaired daily functioning, and lowered quality of life (QoL; Knowles et al., 2018; MikockaWalus et al., 2016a).”
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- Authors
- Knowles, S. R., Graff, L. A., Wilding, H., Hewitt, C., Keefer, L., & Mikocka-Walus, A.
- Affiliations
- The Royal Melbourne Hospital (AU)
- University of Manitoba (CA)
- The University of Melbourne (AU)
- University of York (GB)
- Icahn School of Medicine at Mount Sinai (US)
- Department of Health Sciences, University of York, York, United Kingdom
- Corresponding author
- Knowles, Simon R
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-03-19
- Volume
- 24
- Issue
- 4
- Pages
- 742-751
- ISSN
- 1078-0998 (ISSN-L)
- 1536-4844
- OpenAlex
- W4235023600
- Cited by
- 503
- References
- 54
- Citations by year
- 2026: 57 · 2025: 76 · 2024: 99 · 2023: 91 · 2022: 63 · 2021: 59 · 2020: 30 · 2019: 23 · 2018: 5
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- quality of life, inflammatory bowel disease
- MeSH terms
- Adaptation, Psychological, Anxiety, Depression, Humans, Quality of Life, Severity of Illness Index, Inflammatory Bowel Diseases, Risk Assessment
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