Psychological Effects and Medication Adherence among Korean Patients with Inflammatory Bowel Disease during the Coronavirus Disease 2019 Pandemic: A Single-Center Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Data Analysis
3. Results
3.1. Patient Characteristics
3.2. Mental Well-Being
3.3. Medication Adherence
3.4. Behavioral Changes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Cheema, M.; Mitrev, N.; Hall, L. Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey. BMJ Open Gastroenterol. 2021, 8, e000581. [Google Scholar] [CrossRef] [PubMed]
- Spagnuolo, R.; Larussa, T.; Iannelli, C. COVID-19 and Inflammatory Bowel Disease: Patient Knowledge and Perceptions in a Single Center Survey. Medicina 2020, 56, 407. [Google Scholar] [CrossRef] [PubMed]
- Choi, K.; Chun, J.; Han, K. Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study. J. Clin. Med. 2019, 8, 654. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nahon, S.; Lahmek, P.; Durance, C. Risk factors of anxiety and depression in inflammatory bowel disease. Inflamm. Bowel Dis. 2012, 18, 2086–2091. [Google Scholar] [CrossRef]
- Ronald, K.; Nazar, M.; Laura, F. Quality of life in inflammatory bowel diseases: It is not all about the bowel. Intest. Res. 2021, 19, 45–52. [Google Scholar] [CrossRef] [Green Version]
- Yoon, J.Y.; Shin, J.E.; Park, S.H. Disability due to Inflammatory Bowel Disease is Correlated with Drug Adherence, Disease Activity, and Quality of Life. Gut Liver 2017, 11, 370–376. [Google Scholar] [CrossRef] [Green Version]
- Yun, H.S.; Min, Y.W.; Chang, D.K. Factors associated with vaccination among inflammatory bowel disease patients in Korea. Korean J. Gastroenterol. 2013, 61, 203–208. [Google Scholar] [CrossRef]
- 2020 Inflammatory Bowel Disease Fact Sheet in Korea. Available online: http://m.kasid.org/file/IBD%20fact%20sheet_1217.pdf (accessed on 23 January 2022).
- Lee, Y.J.; Kim, K.O.; Kim, M.C. Perceptions and Behaviors of Patients with Inflammatory Bowel Disease during the COVID-19 Crisis. Gut Liver 2022, 16, 81–91. [Google Scholar] [CrossRef]
- Shah, R.; Dua, A.; Naliboff, B.D. Fear of Covid-19, Along with Stress, Anxiety, and Depression, is Associated with Biologic Usage in Patients with Inflammatory Bowel Disease. Gastroenterology 2021, 160, S335. [Google Scholar] [CrossRef]
- Korean Association for the Study for Intestinal Disease (KASID). Available online: https://www.kasid.org/board/list.html?num=1680&start=0&sort=top%20desc,num%20desc&code=m_bbs&key=&keyword=&cate=54 (accessed on 25 January 2022).
- Zigmond, A.S.; Snaith, P.R. The Hospital Anxiety and Depression Scale. Acta Psychiatr. Scand. 1983, 67, 361–370. [Google Scholar] [CrossRef] [Green Version]
- Thompson, K.; Kulkarni, J.; Sergejew, A.A. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr. Res. 2000, 42, 241–247. [Google Scholar] [CrossRef]
- Chang, J.G.; No, D.Y.; Kim, C.Y. The reliability and validity of the Korean version of Medication Adherence Rating Scale (KMARS). Korean J. Psychopharmacol. 2015, 26, 43–49. [Google Scholar] [CrossRef]
- Kwak, M.S.; Cha, J.M.; Lee, H.H. Emerging trends of inflammatory bowel disease in South Korea: A nationwide population-based study. J. Gastroenterol. Hepatol. 2019, 34, 1018–1026. [Google Scholar] [CrossRef] [PubMed]
- Walker, J.R.; Ediger, J.P.; Graff, L.A. The Manitoba IBD cohort study: A population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders. Am. J. Gastroenterol. 2008, 103, 1989–1997. [Google Scholar] [CrossRef] [PubMed]
- Askar, S.; Sakr, M.A.; Alaty, W.H.A. The psychological impact of inflammatory bowel disease as regards anxiety and depression: A single-center study. Middle East Curr. Psychiatry 2021, 28, 73. [Google Scholar] [CrossRef]
- Coronavirus (COVID-19) Vaccinations. Our World in Data. Available online: https://ourworldindata.org/covid-vaccinations (accessed on 20 January 2022).
- Korea Disease Control and Prevention Agency. Available online: https://www.kdca.go.kr/gallery.es?mid=a20503020000&bid=0003&act=view&list_no=144977 (accessed on 10 January 2022).
- Ministry of Health and Welfare. Available online: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=184&CONT_SEQ=354112 (accessed on 20 December 2021).
- Central Disaster Management Headquarters. Overview of Social Distancing System. Available online: http://ncov.mohw.go.kr/en/socdisBoardView.do?brdId=19&brdGubun=191&dataGubun=191&ncvContSeq=&contSeq=&board_id= (accessed on 20 January 2022).
- Trindade, I.A.; Ferreira, N.B. COVID-19 Pandemic’s Effects on Disease and Psychological Outcomes of People with Inflammatory Bowel Disease in Portugal: A Preliminary Research. Inflamm. Bowel Dis. 2020, 27, 1224–1229. [Google Scholar] [CrossRef]
- Aziz, M.; Fatima, R.; Haghbin, H. The incidence and outcomes of COVID-19 in IBD patients: A rapid review and meta-analysis. Inflamm. Bowel Dis. 2020, 26, e132–e133. [Google Scholar] [CrossRef]
- Barnes, A.; Andrews, J.; Spizzo, P. Medication adherence and complementary therapy usage in inflammatory bowel disease patients during the coronavirus disease 2019 pandemic. JGH Open 2021, 29, 585–589. [Google Scholar] [CrossRef]
- Horne, R.; Weinman, J. Self-regulation and self-management in asthma: Exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol. Health 2002, 17, 17–32. [Google Scholar] [CrossRef]
- Ediger, J.P.; Walker, J.R.; Graff, L. Predictors of medication adherence in inflammatory bowel disease. Am. J. Gastroenterol. 2007, 102, 1417–1426. [Google Scholar] [CrossRef]
- Horne, R.; Parham, R.; Driscoll, R. Patients’ attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflamm. Bowel Dis. 2009, 15, 837–844. [Google Scholar] [CrossRef] [PubMed]
- Jackson, C.A.; Clatworthy, J.; Robinson, A. Factors associated with non-adherence to oral medication for inflammatory bowel disease: A systematic review. Am. J. Gastroenterol. 2010, 105, 525–539. [Google Scholar] [CrossRef] [PubMed]
- Chan, W.; Chen, A.; Tiao, D. Medication adherence in inflammatory bowel disease. Intestig. Res. 2017, 15, 434–445. [Google Scholar] [CrossRef] [PubMed]
- D’Amico, F.; Rahier, J.F.; Leone, S.; Peyrin-Biroulet, L.; Danese, S. Views of patients with inflammatory bowel disease on the COVID-19 pandemic: A global survey. Lancet Gastroenterol. Hepatol. 2020, 5, 631–632. [Google Scholar] [CrossRef]
- Korean Association for the Study for Intestinal Disease (KASID). Available online: https://www.kasid.org/board/list.html?num=1648&start=0&sort=top%20desc,num%20desc&code=ilban&key=&keyword (accessed on 25 January 2022).
- Lee, Y.J.; Kim, S.E.; Park, Y.E. SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: Expert consensus statement by KASID. Korean J. Gastroenterol. 2021, 78, 117–128. [Google Scholar] [CrossRef]
- Stone, M.L.; Feng, M.; Forster, E.M. COVID-19 Pandemic Increased Anxiety Among Patients with Inflammatory Bowel Disease: A Patient Survey in a Tertiary Referral Center. Dig. Dis. Sci. 2021, 1–6. [Google Scholar] [CrossRef]
Characteristic | All (N = 407) |
---|---|
Age (mean ± SD) | 41.82 ± 16.35 |
Gender, n (%) | |
Male | 278 (68.30) |
Female | 129 (31.70) |
Subtype of IBD, n (%) | |
UC | 230 (56.51) |
CD | 177 (43.49) |
PO medication, n (%) | |
Mesalamine | 319 (78.38) |
Steroid | 10 (2.46) |
Immunomodulator | 187 (45.95) |
Biologics | 161 (39.56) |
Disease status, n (%) | |
Remission | 385 (94.59) |
Flare | 22 (5.41) |
Age at IBD diagnosis, mean ± SD | 35.25 ± 15.54 |
Marriage status, n (%) | |
Married | 221 (54.30) |
Unmarried | 186 (45.70) |
Job status, n (%) | |
Employed | 303 (74.81) |
Unemployed | 102 (25.19) |
Presence of mental disease, n (%) | |
Yes | 25 (6.16) |
No | 381 (93.84) |
COVID-19 screening test, n (%) | |
Yes | 192 (47.17) |
No | 215 (52.83) |
COVID-19 screening result, n (%) | |
Positive | 5 (2.05) |
Negative | 239 (97.95) |
Vaccination, n (%) | |
Yes | 189 (45.68) |
No | 220 (54.32) |
Vaccination dose, n (%) | |
1st | 102 (53.97) |
2nd | 87 (46.03) |
HADS total score, mean ± SD | 9.52 ± 6.70 |
KMARS total score, mean ± SD | 7.28 ± 1.49 |
Smoking, n (%) | |
Ex-smoker | 109 (29.70) |
Never | 206 (56.13) |
Current smoker | 52 (14.17) |
Drinking, n (%) | |
Never | 148 (40.22) |
Regular drinking | 35 (9.51) |
Occasional drinking | 185 (50.27) |
Variables | HADS Score | p-Value | CohenD | HADS Anxiety | p-Value | CohenD | HADS Depression | p-Value | CohenD | KMARS Score | p-Value | CohenD |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Gender | 0.01 | −0.29 | <0.001 | −0.41 | 0.18 | −0.54 | 0.73 | 0.04 | ||||
Male | 8.90 ± 6.50 | 3.72 ± 3.24 | 5.18 ± 3.74 | 7.29 ± 1.54 | ||||||||
Female | 10.84 ±6.97 | 5.12 ± 3.76 | 5.73 ± 3.83 | 7.24 ± 1.39 | ||||||||
Marital status | 0.07 | −0.18 | 0.16 | −0.14 | 0.06 | −0.19 | 0.40 | 0.08 | ||||
Married | 8.97 ± 6.57 | 3.94 ± 3.50 | 5.04 ± 3.57 | 7.33 ± 1.56 | ||||||||
Unmarried | 10.16 ±6.82 | 4.42 ± 3.42 | 5.74 ± 3.97 | 7.21 ± 1.41 | ||||||||
Job status | 0.25 | −0.15 | 0.70 | −0.04 | 0.09 | −0.22 | 0.06 | −0.22 | ||||
Employed | 9.25 ± 6.30 | 4.12 ± 3.38 | 5.13 ± 3.50 | 7.21 ± 1.50 | ||||||||
Unemployed | 10.24 ±7.79 | 4.27 ± 3.77 | 5.96 ± 4.44 | 7.53 ± 1.39 | ||||||||
Presence of mental disease | <0.001 | 1.49 | <0.001 | 1.35 | <0.001 | 1.37 | 0.14 | −0.35 | ||||
Yes | 18.32 ±8.59 | 8.36 ± 5.21 | 9.96 ± 4.06 | 6.80 ± 1.68 | ||||||||
No | 8.93 ± 6.15 | 3.88 ± 3.15 | 5.04 ± 3.55 | 7.32 ± 1.46 | ||||||||
IBD subtype | 0.06 | −0.19 | 0.22 | −0.12 | 0.03 | −0.22 | 0.05 | 0.20 | ||||
Ulcerative colitis | 8.97 ± 6.43 | 3.97 ± 3.42 | 5.00 ± 3.59 | 7.40 ± 1.42 | ||||||||
Crohn’s disease | 10.23 ±6.99 | 4.40 ± 3.53 | 5.82 ± 3.96 | 7.11 ± 1.57 | ||||||||
Disease activity | 0.18 | −0.29 | 0.31 | −0.30 | 0.27 | −0.24 | 0.55 | 0.13 | ||||
Remission | 9.41 ± 6.60 | 4.10 ± 3.40 | 5.31 ± 3.74 | 7.29 ± 1.49 | ||||||||
Flare | 11.36 ±8.32 | 5.14 ± 4.60 | 6.23 ± 4.28 | 7.09 ± 1.63 | ||||||||
COVID−19 screening test | 0.33 | 0.10 | 0.19 | 0.13 | 0.61 | 0.05 | 0.41 | −0.08 | ||||
Yes | 9.86 ± 6.81 | 4.40 ± 3.63 | 5.46 ± 3.66 | 7.21 ± 1.44 | ||||||||
No | 9.21 ± 6.61 | 3.94 ± 3.32 | 5.27 ± 3.88 | 7.33 ± 1.54 | ||||||||
Vaccination | 0.01 | −0.28 | 0.01 | −0.26 | 0.01 | −0.25 | 0.07 | 0.18 | ||||
Yes | 8.48 ± 6.17 | 3.64 ± 3.36 | 4.83 ± 3.39 | 7.43 ± 1.47 | ||||||||
No | 10.32 ±7.01 | 4.55 ± 3.49 | 5.77 ± 4.03 | 7.16 ± 1.49 |
Anxiety | Depression | |||||||
---|---|---|---|---|---|---|---|---|
Characteristics | Univariate Analysis OR (95% CI) | p-Value | Multivariate Analysis OR (95% CI) | p-Value | Univariate Analysis OR (95% CI) | p-Value | Multivariate Analysis OR (95% CI) | p-Value |
Age | 1 (0.98, 1.02) | 0.928 | 1.03 (0.98, 1.08) | 0.318 | 1 (0.98, 1.01) | 0.694 | 1 (0.96, 1.05) | 0.936 |
Gender (male vs. female) | 0.42 (0.24, 0.73) | 0.002 | 0.38 (0.2, 0.71) | 0.003 | 0.67 (0.42, 1.06) | 0.087 | 0.57 (0.34, 0.95) | 0.032 |
Marital status (married vs. unmarried) | 1.08 (0.62, 1.88) | 0.786 | 0.97 (0.43, 2.19) | 0.941 | 0.77 (0.5, 1.2) | 0.250 | 0.65 (0.34, 1.24) | 0.188 |
Job status (employed vs. unemployed) | 0.81 (0.44, 1.49) | 0.488 | 1.12 (0.55, 2.26) | 0.760 | 0.84 (0.51, 1.39) | 0.505 | 1.16 (0.65, 2.05) | 0.616 |
Presence of mental disease (yes vs. no) | 7.89 (3.4, 18.33) | <0.0001 | 9.39 (3.74, 23.57) | <0.0001 | 10.69 (4.14, 27.61) | <0.0001 | 12.77 (4.67, 34.95) | <0.0001 |
Age at IBD diagnosis | 0.99 (0.98, 1.01) | 0.523 | 0.98 (0.94, 1.03) | 0.471 | 1 (0.98, 1.01) | 0.809 | 1.02 (0.97, 1.06) | 0.461 |
COVID-19 screening test (yes vs. no) | 1.01 (0.58, 1.76) | 0.962 | 0.94 (0.51, 1.73) | 0.844 | 1.03 (0.66, 1.6) | 0.906 | 0.95 (0.58, 1.54) | 0.823 |
Vaccination (yes vs. no) | 0.63 (0.36, 1.13) | 0.120 | 0.4 (0.19, 0.84) | 0.016 | 0.68 (0.43, 1.07) | 0.093 | 0.5 (0.28, 0.89) | 0.019 |
Subtype of IBD | 0.344 | 0.050 | 0.055 | 0.034 | ||||
Ulcerative colitis | 0.77 (0.44, 1.33) | 0.44 (0.2, 1) | 0.65 (0.42, 1.01) | 0.5 (0.27, 0.95) | ||||
Crohn’s disease | Index | Index | Index | 0.055 | Index | |||
PO medication | ||||||||
Mesalamine (yes vs. no) | 1.15 (0.6, 2.21) | 0.671 | 1.12 (0.47, 2.64) | 0.800 | 1.07 (0.63, 1.81) | 0.813 | 0.7 (0.36, 1.37) | 0.293 |
Steroid (yes vs. no) | 1.54 (0.19, 12.38) | 0.685 | 2.88 (0.28, 29.31) | 0.371 | 0.23 (0.06, 0.82) | 0.024 | 0.23 (0.06, 0.92) | 0.038 |
Immunomodulator (yes vs. no) | 1.4 (0.79, 2.45) | 0.247 | 2.35 (1.08, 5.12) | 0.031 | 1.01 (0.65, 1.57) | 0.971 | 1.49 (0.81, 2.74) | 0.205 |
Biologics (yes vs. no) | 1.59 (0.88, 2.88) | 0.127 | 1.62 (0.77, 3.4) | 0.206 | 0.97 (0.62, 1.51) | 0.877 | 0.86 (0.49, 1.51) | 0.595 |
Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|
β | 95% CI | p-Value | β | 95% CI | p-Value | |
HADS Anxiety | −0.102 | −0.142 to −0.061 | <0.0001 | −0.074 | −0.135 to −0.013 | 0.018 |
HADS Depression | −0.078 | −0.116 to −0.040 | <0.0001 | −0.021 | −0.076 to 0.035 | 0.466 |
Gender (male vs. female) | 0.055 | −0.258 to 0.368 | 0.732 | 0.006 | −0.312 to 0.324 | 0.972 |
Marital status (married vs. unmarried) | 0.125 | −0.167 to 0.417 | 0.400 | −0.045 | −0.403 to 0.313 | 0.804 |
Job status (employed vs. unemployed) | −0.318 | −0.650 to 0.014 | 0.060 | −0.352 | −0.695 to −0.010 | 0.044 |
Presence of mental disease (yes vs. no) | −0.520 | −1.120 to 0.078 | 0.089 | −0.069 | −0.702 to 0.564 | 0.830 |
Age at IBD diagnosis | 0.010 | 0.001 to 0.020 | 0.031 | 0.003 | −0.010 to 0.016 | 0.678 |
COVID−19 screening test (yes vs. no) | −0.121 | −0.413 to 0.170 | 0.414 | −0.043 | −0.330 to 0.244 | 0.768 |
Vaccination (yes vs. no) | 0.269 | −0.022 to 0.560 | 0.070 | 0.137 | −0.188 to 0.461 | 0.409 |
Subtype of IBD (Ulcerative colitis vs. Crohn’s disease) | 0.291 | −0.001 to 0.584 | 0.051 | 0.181 | −0.199 to 0.561 | 0.350 |
PO medication | ||||||
Mesalamine (yes vs. no) | 0.238 | −0.115 to 0.591 | 0.186 | 0.071 | −0.328 to 0.471 | 0.726 |
Steroid (yes vs. no) | 0.023 | −0.918 to 0.964 | 0.962 | 0.032 | −0.889 to 0.952 | 0.946 |
Immunomodulator (yes vs. no) | −0.256 | −0.548 to 0.035 | 0.084 | −0.153 | −0.508 to 0.202 | 0.398 |
Biologics (yes vs. no) | 0.034 | −0.264 to 0.332 | 0.823 | 0.203 | −0.134 to 0.540 | 0.236 |
Variables | n * (%) |
---|---|
Reduced time with friends | 129 (76.8) |
More communication with people about health | 110 (65.5) |
Delay tasks to do | 75 (44.6) |
Shopping for certain types of food | 72 (42.9) |
Reduced time with family | 63 (37.5) |
Increased efforts to access health care service | 51 (30.4) |
Increased efforts to obtain medication | 31 (18.5) |
Increased frequency to smoke | 15 (8.9) |
Increased frequency to drink alcohol | 12 (7.1) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ryu, J.E.; Kang, S.-G.; Jung, S.H.; Lee, S.H.; Kang, S.-B. Psychological Effects and Medication Adherence among Korean Patients with Inflammatory Bowel Disease during the Coronavirus Disease 2019 Pandemic: A Single-Center Survey. J. Clin. Med. 2022, 11, 3034. https://doi.org/10.3390/jcm11113034
Ryu JE, Kang S-G, Jung SH, Lee SH, Kang S-B. Psychological Effects and Medication Adherence among Korean Patients with Inflammatory Bowel Disease during the Coronavirus Disease 2019 Pandemic: A Single-Center Survey. Journal of Clinical Medicine. 2022; 11(11):3034. https://doi.org/10.3390/jcm11113034
Chicago/Turabian StyleRyu, Ji Eun, Sung-Goo Kang, Sung Hoon Jung, Shin Hee Lee, and Sang-Bum Kang. 2022. "Psychological Effects and Medication Adherence among Korean Patients with Inflammatory Bowel Disease during the Coronavirus Disease 2019 Pandemic: A Single-Center Survey" Journal of Clinical Medicine 11, no. 11: 3034. https://doi.org/10.3390/jcm11113034