P1233 Socio- demographic determinants of fatigue in patients with inflammatory bowel disease in remission: SOFA study
Authors: Ferrari T , Hupe M , Altwegg R , Nancey S , Riviere P , Costentin C , Mathieu N 
Published: January 2025

Background

Social determinants of health are recognized in patients with inflammatory bowel disease (IBD)1, but their impact on fatigue is less well understood. A study by GETAID suggests a link between fatigue and social factors, although these are not detailed2. Our study aims to describe the socio-demographic determinants of fatigue (SDF) in IBD patients in remission.

Methods

This is a French, descriptive, cross-sectional, multicenter (4 university hospitals) cohort study conducted in real-life settings. Included patients are adults with IBD in clinical and biological remission for at least 6 months, who also report significant fatigue (assessed by a FACIT-F score &lt; 40). SDF are collected using several questionnaires: the DIPCare3 (assesses deprivation in social, material, and healthcare, total score from 0 to 5, higher score indicates greater deprivation) and the SSQ64 (social support, score from 0 to 54, and patient satisfaction, score from 6 to 36, higher scores indicate greater support). Disability is assessed using the IBD disk. The primary outcome is the description of SDF in IBD patients with significant fatigue and clinico-biological remission. The secondary outcome compared SDF between moderately fatigued (30 ≤ FACIT-F &lt; 40) and severely fatigued patients (FACIT-F &lt; 30).

Results

A total of 209 patients fatigued patients (102 moderately and 107 severely) were included, with a mean FACIT-F score of 27.78 (± 9.55). The mean total DIPCare score is 1.32 (± 1.2), with social deprivation score of 1.43 (± 1.25), healthcare deprivation score of 0.23 (± 0.42), and material deprivation score of 0.68 (± 0.79). The mean SSQ6 scores are 16.85 (± 10.1) for readiness and 28.17 (± 8.2) for satisfaction. Fatigue is associated with disability (mean IBD disk score: 48.71 ± 20.56), with score significantly worse in severely fatigued patients compared to moderately fatigued patients (mean IBD disk score: 56.49 ± 18.81 vs 40.46 ± 19.07; p &lt; 0.001). DIPCare deprivation scores are higher in severely fatigued patients compared to moderately fatigued patients (mean score: 1.32 ± 1.2 vs 1.02 ± 1.1; p &lt; 0.001). For the SSQ6, severely fatigued patients had lower social support readiness (mean score: 14.81 ± 9.04 vs 18.99 ± 10.69, p = 0.004) and were less satisfied with their support (mean score: 26.93 ± 8.26 vs 29.46 ± 7.93, p = 0.026) than moderately fatigued patients.

Conclusion

Severe fatigue (FACIT-F &lt; 30) in IBD patients in remission is associated with increased deprivation, reduced social support, lower satisfaction with readiness support, and significant disability. Until interventional studies are available, it is crucial to consider SDF as part of holistic, patient- centered care.

References

1-Anyane-Yeboa A, Quezada S, Rubin DT, Balzora S. The Impact of the Social Determinants of Health on Disparities in Inflammatory Bowel Disease. Clin Gastroenterol Hepatol. 2022;20(11):2427-2434. doi:10.1016/j.cgh.2022.03.011

2-Amiot A, Chaibi S, Bouhnik Y, et al. Prevalence and Determinants of Fatigue in Patients with IBD: A Cross-Sectional Survey from the GETAID. J Crohns Colitis. 2023;17(9):1418-1425. doi:10.1093/ecco-jcc/jjad060

3-Vaucher P, Bischoff T, Diserens EA, et al. Detecting and measuring deprivation in primary care: development, reliability and validity of a self-reported questionnaire: the DiPCare-Q. BMJ Open. 2012;2(1):e000692. doi:10.1136/bmjopen-2011-000692

4-Rascle N, Bruchon-Schweitzer M. SHORT FORM OF SARASON’S SOCIAL SUPPORT QUESTIONNAIRE: FRENCH ADAPTATION AND VALIDATION ‘.