Lower Quality of Life Contributes to Presenteeism in Patients with Crohn's Disease in Remission

It is known that Crohn's disease (CD) patients experience impaired work productivity, and balancing between managing disease and work is a significant challenge. In this study, we analyzed factors influencing work productivity in patients with CD in remission. 672 patients enrolled in iCREST-CD from December 2018 to June 2020 were included. Disease severity, work productivity, fatigue, and QoL were assessed using the Harvey Bradshow index (HBI), the WPAI-GH questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F), and Short-form Inflammatory Bowel Disease QoL (SIBDQ), respectively. Of the 437 patients with HBI recorded at the time of consent, 355 (81.2%) were in remission. In the remission/non-remission group, the mean WPAI subscores were 6.4/23.2 for absenteeism and 25.7/42.1 for presenteeism. Factors linked to impaired work productivity included a reduced QOL related to absenteeism, and both a reduced QOL and elevated C-reactive protein levels associated with presenteeism. Furthermore, in 53 patients in remission, who exhibited presenteeism without absenteeism, reduced QoL was identified as a relevant factor. Our study found that a significant number of patients with Crohn's disease (CD) reported presenteeism even during remission, and that reduced QoL is a relevant factor.