Disease Acceptance, but not Perceived Control, is Uniquely Associated with Inflammatory Bowel Disease-related Disability.

Background and Aims Disability, an important aspect of disease burden in patients with inflammatory bowel disease [IBD], has been suggested as a valuable clinical endpoint. We aimed to investigate how disease acceptance and perceived control, two psychological predictors of subjective health, are associated with IBD-related disability. Methods In this cross-sectional study, adult IBD patients from the University Hospitals Leuven received a survey with questions about clinical and demographic characteristics, disease acceptance and perceived control [Subjective Health Experience model questionnaire], and IBD-related disability [IBD Disk]. Multiple linear regressions assessed predictors of IBD-related disability in the total sample and in the subgroups of patients in clinical remission or with active disease. Results In the total sample (N  = 1250, 54.2% female, median [interquartile range: IQR] age 51 [39–61] years, 61.3% Crohn's disease, 34.9% active disease), adding the psychological predictors to the model resulted in an increased explained variance in IBD-related disability of 19% compared with a model with only demographic and clinical characteristics [ R ² _adj 38% vs 19%, p  <0.001]. The increase in explained variance was higher for patients in clinical remission [Δ R ² _adj 20%, p  <0.001] compared with patients with active disease [Δ R ² _adj 10%, p  <0.001]. Of these predictors, disease acceptance was most strongly associated with disability in the total sample [ β  = -0.44, p  <0.001], as well as in both subgroups [ β  = -0.47, p  <0.001 and β  = -0.31, p  <0.001 respectively]. Perceived control was not significantly associated with disability when accounting for all other predictors. Conclusions Disease acceptance is strongly associated with IBD-related disability, supporting further research into disease acceptance as a treatment target. [ABSTRACT FROM AUTHOR]