Patients with inflammatory bowel disease (IBD) frequently reported moderate disease-related anxiety during the COVID-19 pandemic, according to study results published in Journal of Gastroenterology.
Researchers in Japan analyzed questionnaires that assessed anxiety and behavioral changes in patients with IBD during the COVID-19 pandemic from March 2020 to June 2021.
The questionnaire included 6 major domains that assessed the impact of COVID-19 on anxiety related to IBD, disease activity, medical examination, IBD medication, and infection prevention. The primary outcome was the 10-point visual analog scale (VAS) score for disease-related anxiety during the pandemic.
A total of 3790 questionnaires were distributed, of which 3049 (80.4%) were returned and 3032 were analyzed. The participants were a median age of 44 (range, 16-92) years, and 43.3% were women. Of the cohort, 60.6% of patients were diagnosed with ulcerative colitis and 39.4% had Crohn disease.
Participants’ mean VAS score during the pandemic was 5.1±2.5, indicating moderate anxiety. An increasing tendency was observed in anxiety scores 1 month after the number of infected persons per population increased, according to Pearson correlation coefficients.
Univariate and multivariate analyses showed that female sex, homemaker status, arrival time at hospital from home, and usual means of commuting to the hospital (ie, train) were significant factors for VAS anxiety scores.
Medication use for IBD, visiting the hospital, and receiving a medical examination as scheduled and postponing the examination also significantly affected anxiety scores. Multivariate analysis showed that patients’ anxiety scores decreased significantly after the start of vaccination in March 2021.
About 90% of participants went to the hospital and received treatment as scheduled during the pandemic. Of the 9.9% of participants who could not visit the hospital or postponed their visit, 53.1% voluntarily postponed their visits, and 45.4% were advised by their physicians to do so. In addition, 97.5% of participants continued oral medication and injections as recommended by their physicians during the pandemic, 1.9% reduced their medication dose, and 0.6% discontinued medication.
Participants were highly satisfied with receiving an explanation of the continuation of IBD medication (median VAS score, 10), with 42.6% receiving an explanation from their physicians. After receiving the explanation, 45.7% of participants reported that their anxiety was the same, although a majority had a score of less than 5 on the VAS.
Among the responders, 35.6% received information about COVID-19 infection prevention from their physicians compared with 64.4% who did not. Most participants were satisfied with the explanation (median VAS score, 8).
A total of 48.5% of participants had an endoscopic examination as scheduled, 11.4% postponed it, and 1.5% did not continue it. When patient behavioral changes before vaccination in February 2021 were compared with those after the start of vaccination in March 2021, only endoscopic examination was associated with significant changes.
The study is limited by the fact that the primary outcome was measured with a single item, and the cross-sectional design limited interpretations of the long-term effects of the pandemic. The absence of a control group limited comparisons of the results with findings in other adult populations.
“Future researchers and health care professionals should continue to proactively inform patients about infectious diseases including COVID-19 and provide accurate corresponding information related to IBD care, thereby relieving patient anxiety as much as possible,” the researchers conclude.
Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Nakase H, Wagatsuma K, Nojima M, et al. Anxiety and behavioral changes in Japanese patients with inflammatory bowel disease due to COVID-19 pandemic: a national survey. J Gastroenterol. Published online January 6, 2023. doi:10.1007/s00535-022-01949-6