N37 Inflammatory Bowel Disease-Fatigue (IBD-F) patient self-assessment scale and its use in research and clinical practice - a systematic review
Authors: Chalmers D R , Paramasivan S , Watson N , Czuber-Dochan W 
Published: January 2025

Background

Individuals living with inflammatory bowel disease (IBD) report fatigue as most common and disabling symptom, with 86% reporting fatigue in active IBD and 50% in remission. It is however, poorly understood and inadequately addressed in clinical setting. There are several scales that have been used to assess fatigue in IBD (1), however only the IBD-F patient self-assessment scale (2) has been developed and validity tested with people with IBD. The IBD-F scale has been recommended as the gold standard by recent literature review (3). The aim of the current review is to understand the IBD-F scale usage in clinical and academic environments and what impact the scale has had since its publication in clinical practice and research including utilisation.

Methods

We searched AMED (APA PsycInfo, CINAHL Plus, Medline), Embase, Scopus, PubMed, Psycarticles from Jan 2014 (date of the IBD-F scale publication) to Jul 30, 2023, to identify the studies reporting the use and/or translation of the IBD-F scale. Studies were eligible if they used the IBD-F scale and were written in English, unless a translation was made available. Titles and abstracts screening and data extraction were conducted by two reviewers independently.

Results

In total 1457 references were identified from the databases, imported to Covidence and duplicates (n=365) removed. Titles and abstracts (n=1092) screening resulted in 21studies fulfilling the eligibility criteria; five cross-sectional surveys, four randomised controlled trials (RCTs), and 12 translation and validation studies. All were high or medium quality. The total population size of the included studies was 6126 participants (30-1700 range) of which 3612 were females.

Due to heterogeneity of studies, meta-analysis was precluded. Most studies (n=15) were conducted in one country (UK, Denmark, China, Korea, Germany, Iran and Mexico) and six were international collaborations (Greece/UK, Brazil/UK, Denmark/Norway, Netherlands/UK, Poland/UK, and Bulgaria/France/Israel/Norway/Italy/Spain/Sweden/UK). This indicates a broad international focus on IBD fatigue. Most studies (n=17) concentrated on factors contributing to and measuring prevalence and severity of fatigue. Only four were RCTs focusing of fatigue management.

Conclusion

The IBD-F scale is a tool with a high content and face validity to assess the multidimensional nature of fatigue experienced by individuals with IBD. The IBD-F scale has been primarily used in clinical and academic research. There were no studies reporting using IBD-F scale in clinical practice. Health professionals need to adopt the scale in clinical practice to systematically assess and manage IBD fatigue.

References

(1)Borren NZ, van der Woude JC and Ananthakrishnan AN. Fatigue in IBD: epidemiology, pathophysiology and management. Nature Reviews Gastroenterology & Hepatology. 2019 Apr;16(4):247-259. https://doi:10.1038/s41575-018-0091-9

(2)Czuber-Dochan W, Norton C, Bassett P, et al. Development and psychometric testing of inflammatory bowel disease fatigue (IBD-F) patient self-assessment scale. JCC. 2014 Nov; 8(11):1398-1406. https://doi.org/10.1016/j.crohns.2014.04.013

(3)Fan VSK, Mehdipour A, O'Grady, et al. Systematic review: patient-reported outcome measures of fatigue in inflammatory bowel disease. Fatigue: Biomedicine, Health & Behavior. 2022 May; 10(2):60-82. https://doi.org/10.1080/21641846.2022.2073157