N06 Zero disability in IBD-disk: a workshop interventional program
Authors: Cano Sanz N , Latras Cortés I , Suárez Álvarez P , Sierra Ausín M 
Published: January 2025

Background

Inflammatory bowel disease (IBD) is a chronic and systemic disease that worsens quality of life, even in patients in remission. Half of those diagnosed have fatigue and a third have anxiety. Reducing disability is one of goals of treatment, included in the STRIDE-II document. However, measuring disability in daily practice can be challenging. The IBD-disk is a visual tool with short, self-administered questions that can be used to improve communication with the patient, as it assesses different areas which we are not usually explored during consultation (emotions, relationships, sexuality, body image, sleep quality, etc.). Its score measures the degree of disability related to the disease, and is significantly associated with clinical activity scores. Thus, we pursued a double objective with our project:

- To measure the degree of disability in our population of patients in maintained remission by means of the IBD-disk

- To develop a workshop program to impact in those areas where our patients showed selectively higher degrees of disability.

Methods

Patients with severe IBD, on biological and/or immunosuppressive treatment, with an average duration of the disease of &gt; 10 years and in clinical and biological remission for at least 12 months were included to meet the first objective of the program. Afterwards, a sample of patients with IBD-disk score ≥ 40 points was selected, placing a cut-off point to consider significant disability in any of the areas considered in IBD-disk at ≥ 5 points. These areas would be included in a program of workshops where the patients with IBD-disk score ≥ 40 points would be invited to attend.

Results

60 patients were evaluated with IBD-disk. 34.1% of the patient had significant disability and were selected for the workshop program. Those with higher inflammation biomarkers more frequently showed disability, reaching statistical significance. We found no differences between disability, sex or type of IBD. The areas that most frequently determined disability were observed in energy, sleep quality, mobility-joint pain and fecal continence-abdominal pain. Thus, 4 workshops were defined for this purpose.

During the workshops, the degree of satisfaction was high among the participants (average 4.8/5). To abstract date, results from 14 patients have been obtained, showing a significative reduction in IBD-disk average score (before workshops 64.8 points vs. after workshops 48.2 points; p &lt; 0.02).

Conclusion

Disability is high in patients with IBD, even if they meet criteria for good disease control. Thanks to a focused workshops program, disability of the patients can be improved with significative reduction of the score measured by IBD-disk.

References

1.Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021;160(5):1570–83.

2.Ghosh S, Louis E, Beaugerie L, Bossuyt P, Bouguen G, Bourreille A, et al. Development of the IBD Disk: A Visual Self-administered Tool for Assessing Disability in Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2017 Mar;23(3):333-340.

3.Amiot A, Chaibi S, Bouhnik Y, Serrero M, Filippi J, Roblin X, et al.; GETAID-patient experience study group. Prevalence and Determinants of Fatigue in Patients with IBD: A Cross-Sectional Survey from the GETAID. J Crohns Colitis. 2023 Oct 20;17(9):1418-1425.