Location: Children's Nutrition Research CenterTitle: Gastrointestinal symptoms predictors of health-related quality of life in patients with inflammatory bowel disease
|VARNI, JAMES - Texas A&M University|
|SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)|
|SELF, MARIELLA - Baylor College Of Medicine|
|SAEED, SHEHZAD - Cincinnati Children'S Research Hospital|
|PATEL, ASHISH - University Of Texas Southwestern Medical Center|
|NURKO, SAMUEL - Boston Children'S Hospital|
|NEIGUT, DEBORAH - Children'S Hospital - Denver, Colorado|
|SAPS, MIGUEL - Northwestern University|
|FRANCIOSI, JAMES - Cincinnati Children'S Research Hospital|
|DENHAM, JOLANDA - Columbus Children'S Hospital|
|ZACUR, GEORGE - Cincinnati Children'S Research Hospital|
|DARK, CHELSEA - Texas A&M University|
|BENDO, CRISTIANE - Federal University Of Minas Gerais|
|POHL, JOHN - Primary Children'S Medical Center|
Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/27/2016
Publication Date: 12/1/2016
Citation: Varni, J.W., Shulman, R.J., Self, M.M., Saeed, S.A., Patel, A.S., Nurko, S., Neigut, D.A., Saps, M., Franciosi, J.P., Denham, J.M., Zacur, G.M., Dark, C.V., Bendo, C.B., Pohl, J.F. 2016. Gastrointestinal symptoms predictors of health-related quality of life in patients with inflammatory bowel disease. Journal of Pediatric Gastroenterology and Nutrition. 63(6):e186-e192.
Interpretive Summary: Children with inflammatory bowel disease need to be under constant medical care. We used a questionnaire to learn about their quality of life. Gastrointestinal symptoms accounted for half of their quality of life. We identified specific symptoms that could be targeted to improve their quality of life.
Technical Abstract: The aim of the study was to investigate the multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with inflammatory bowel disease from the perspectives of pediatric patients and parents. The Pediatric Quality of Life Inventory Gastrointestinal Symptoms Scales and Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 260 families of patients with inflammatory bowel disease. Gastrointestinal Symptoms Scales measuring stomach pain, food and drink limits, gas and bloating, constipation, blood in stool, and diarrhea were identified as clinically important symptom differentiators from healthy controls based on prior findings, and subsequently tested for bivariate and multivariate linear associations with overall HRQOL (Generic Core Scales). Stomach pain, food and drink limits, gas and bloating, constipation, blood in stool, and diarrhea were significantly associated with decreased HRQOL in bivariate analyses (P<0.001). In predictive models utilizing hierarchical multiple regression analyses controlling for age, sex, and race/ethnicity, gastrointestinal symptoms accounted for an additional 40% of the variance in patient self-reported HRQOL (P<0.001) and 37% of the variance in parent proxy-reported HRQOL (P<0.001), reflecting large effect sizes. Stomach pain, food and drink limits, and constipation were significant individual patient-reported predictors after controlling for the other gastrointestinal symptoms in the predictive models. Patient-reported gastrointestinal symptoms differentially predicted HRQOL. Identifying the specific gastrointestinal symptoms from a standardized multidimensional gastrointestinal symptoms profile that are the most important predictors from the patient perspective facilitates a patient-centered approach for interventions designed to ameliorate impaired HRQOL.