title: Back/joint pain, illness perceptions and coping are important predictors of quality of life and work productivity in patients with inflammatory bowel disease: a 12-month longitudinal study.
abstract: OBJECTIVE
  Back and joint pain are the most common extraintestinal symptoms reported by patients with inflammatory bowel disease (IBD). We assessed the impact of back/joint pain, illness perceptions, and coping on quality of life (QOL) and work productivity in patients with IBD.
  
  
  METHODS
  Our cohort included 155 IBD patients with and 100 without arthropathy. Arthropathy was defined as daily back pain for ≥3 months and/or peripheral joint pain and/or joint swelling over the last year. At baseline and at 12 months, patients completed questionnaires on the extent of back/joint pain, IBD disease activity, illness perceptions, coping, QOL, and work productivity. The impact of back/joint pain, illness perceptions and coping on QOL and work productivity was determined, using linear mixed models.
  
  
  RESULTS
  In total, 204 IBD patients (72% Crohn's disease, 40% male, mean age 44 ± 14 years) completed questionnaires at both time points. At both time points, IBD patients with back/joint pain reported a significantly lower QOL and work productivity compared with IBD patients without back/joint pain. Predictors of low QOL were back/joint pain (β = -1.04, 95% confidence interval [CI] -1.40, -0.68), stronger beliefs about the illness consequences (β = -0.39, 95% CI -0.59, -0.18) and emotional impact of IBD (β = -0.47, 95% CI -0.66, -0.28), and the coping strategy 'decreasing activity' (β = -0.26, 95% CI -0.48, -0.03). Predictors of work productivity were back/joint pain (β = 0.22, 95% CI 0.07, 0.37) and illness consequences (β = 0.14, 95% CI 0.06, 0.22).
  
  
  CONCLUSIONS
  Back/joint pain, illness perceptions, and coping are significant predictors of QOL and work productivity, after controlling for disease activity.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Mike
authors.initials: M
authors.lastname: van der Have
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Lianne K P M
authors.initials: LK
authors.lastname: Brakenhoff
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Sanne J H
authors.initials: SJ
authors.lastname: van Erp
authors.affiliation: Section of Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Ad A
authors.initials: AA
authors.lastname: Kaptein
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Max
authors.initials: M
authors.lastname: Leenders
authors.affiliation: Section of Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Scharloo
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Roeland A
authors.initials: RA
authors.lastname: Veenendaal
authors.affiliation: Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Désirée M F M
authors.initials: DM
authors.lastname: van der Heijde
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: van der Meulen-de Jong
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands Centre for Inflammatory Bowel Diseases, UCLA Health System, Los Angeles, CA, USA.
authors.forename: Daan W
authors.initials: DW
authors.lastname: Hommes
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Herma H
authors.initials: HH
authors.lastname: Fidder
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000523:psychology*; D001416:Back Pain / Q000209:etiology / Q000523:psychology*; D004526:Efficiency; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000523:psychology; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010465:Perception; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Arthralgia; Common Sense Model; coping; illness perceptions; inflammatory bowel disease; quality of life; work productivity