Longitudinal Changes in Symptom Cluster Membership in Inflammatory Bowel Disease

Area of Science:

• Gastroenterology and Immunology
• Patient-Reported Outcomes
• Chronic Disease Management

Background:

• Inflammatory bowel disease (IBD) presents with complex symptom clusters.
• Understanding the trajectory of these symptom clusters is crucial for effective patient management.
• Previous research has not fully elucidated the stability and predictors of change in IBD symptom clusters.

Purpose of the Study:

• To describe changes in symptom cluster membership over one year in adults with IBD.
• To identify demographic and clinical factors predicting transitions between symptom clusters.

Main Methods:

• Retrospective longitudinal study using the Crohn's & Colitis Foundation of America Partners Cohort (2012-2015).
• Latent transition analysis assessed symptom cluster changes at baseline, 6, and 12 months.
• Multinomial regressions examined predictors of cluster transition, measuring pain, fatigue, sleep, depression, and anxiety.

Main Results:

• Four stable symptom clusters were identified: high symptom burden (32.3%-35.3%), low symptom burden (24.2%-27.1%), physical symptoms (19.0%-20.9%), and psychological symptoms (20.0%-21.5%).
• High stability was observed, with probabilities of remaining in the same cluster ranging from .814 to .905.
• Transition from active disease to remission was associated with shifts from high burden to low burden and psychological symptom clusters.

Conclusions:

• Symptom cluster membership in IBD patients demonstrates significant stability over a one-year period.
• Further research is needed to understand the etiology of these clusters and develop targeted interventions.
• Personalized symptom management strategies that address multiple symptoms are recommended for IBD patients.