QUALITY-OF-LIFE - MEASUREMENT IN INFLAMMATORY BOWEL-DISEASE

Health-related Quality of Life (HRQOL) is gaining increased notoriety in the study of chronic diseases. These indices provide a subjective, quantitative assessment of health perception and function in the physi cal, social and emotional domains which is distinct from measures of d isease activity. HRQOL tools can be promoted to evaluate the natural h istory of the disease, to catalogue the needs of inflammatory bowel di sease (IBD) patients, to focus the direction of research and allocatio n of limited resources, and to assess outcome in clinical trials. Whil e generic measures of HRQOL permit comparison among disease population s, they may be too imprecise to reflect impairment of function in youn g IBD patients or to gauge response to therapy. Several IBD specific H RQOL measures have been developed to address these applications. A sur vey using the McMaster IBDQ showed that 182 IBD patients had significa ntly worse HRQOL than 48 normal controls. Several studies have observe d that patients with ulcerative colitis experience better HRQOL than t hose with Crohn's disease and Crohn's patients who have had surgery ha ve an even poorer HRQOL. Two clinical trials in Crohn's disease have u tilized the IBDQ to measure therapeutic efficacy and demonstrated that HRQOL compared favourably with other measures of outcome. Self-admini stration of the IBDQ may reduce costs of clinical research without alt ering results. Future direction of HRQOL in IBD may be targeted at lon g-range assessment of costs and benefits to therapy.