Abstract
Background and aimsThe disease-related knowledge levels in patients with inflammatory bowel disease (IBD) are important because it could affect the self-management ability and adaptive coping strategies. We set out to determine whether higher levels of disease-related knowledge reduce medical acceleration.MethodsWe evaluated the levels of disease-related knowledge in all patients at the time of enrollment for SNUBH IBD cohort using the validated IBD-KNOW questionnaire. Clinical data were prospectively collected and the factors related to step-up therapy were analyzed. Step-up therapy was defined as the new use of corticosteroids, immunomodulators, or biologics after the enrollment.ResultsBetween April 2017 and January 2019, 298 patients were enrolled (mean age, 39.8 years; males, 69.5%); 193 patients (64.8%) had ulcerative colitis and 105 (35.2%) had Crohn’s disease. The mean disease duration was 35.8 months. During the mean follow-up of 14.7 months, 90 patients (30.2%) underwent step-up therapy and 208 (69.8%) underwent continuous therapy. The prevalence of continuous therapy increased with increasing IBD-KNOW scores (p for trend = 0.019). Cox proportional hazards analysis revealed that high IBD-KNOW scores (≥ 16) (hazards ratio [HR]: 0.498, 95% confidence interval [CI]: 0.276–0.897, p = 0.020) was negatively associated with the step-up therapy.ConclusionsHigher disease-related knowledge could reduce the requirement of step-up therapy in IBD. The IBD-KNOW score was independently predictive of step-up therapy.
Highlights
Inflammatory bowel disease (IBD) has become a global disease affecting 3.5 million people with accelerating incidence in newly industrialized countries including the Republic of Korea. [1, 2] The medical therapy for inflammatory bowel disease (IBD) involves different drug categories, including 5-aminosalicylates (5-ASA), corticosteroids, immunomodulators, and biologics
We evaluated the levels of disease-related knowledge in all patients at the time of enrollment for SNUBH IBD cohort using the validated IBD-KNOW questionnaire
Cox proportional hazards analysis revealed that high IBDKNOW scores ( 16) was negatively associated with the step-up therapy
Summary
Inflammatory bowel disease (IBD) has become a global disease affecting 3.5 million people with accelerating incidence in newly industrialized countries including the Republic of Korea. [1, 2] The medical therapy for IBD involves different drug categories, including 5-aminosalicylates (5-ASA), corticosteroids, immunomodulators, and biologics. [8] Further, higher levels of knowledge of the disease seem to positively impact the adherence and patient outcomes in IBD. [11] CCKNOW is not indicative of updated knowledge such as that regarding biologic therapy and has several limitations such as the uneven distribution of disease-specific items and a higher correct answer ratio of “true.” a novel disease-related knowledge score, the Inflammatory Bowel Disease Knowledge (IBD-KNOW) score, was developed and validated. [14, 15] to our knowledge, the association between disease-related knowledge levels of IBD and clinical outcomes such as medical acceleration has not been studied so far. We set out to determine whether higher levels of disease-related knowledge regarding IBD reduce medical acceleration in patients using the IBD-KNOW questionnaire. The disease-related knowledge levels in patients with inflammatory bowel disease (IBD) are important because it could affect the self-management ability and adaptive coping strategies.
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