ABSTRACT
Introduction Many people with chronic diseases experienced a heightened sense of vulnerability as information emerged about COVID-19 risk, especially in those with underlying health conditions. Persons with and without IBD, experienced stress surrounding their health, finances, and employment. Physical isolation may have enhanced this stress. There may have been an increase in maladaptive behaviors, perhaps as a response to these stressors. We sought to assess these stressors and maladaptive behaviors people with IBD turned to during the pandemic. Methods Participants in the population-based University of Manitoba IBD Research Registry (n=2833) were invited to participate in a survey regarding their experiences with COVID-19, during autumn 2020, just prior to and during the second pandemic wave in Manitoba. The survey included background sociodemographic and disease information (e.g., symptom severity, medication use), COVID-related personal and health circumstances and coping. Results There were 1384 respondents (48.9%). The mean age of respondents was 57.8 years, 59.3% were female and 46.9% had Crohn's disease. 10.8% of respondents experienced reduced hours in their job, while 8.0% lost their job. 43.8% of respondents were working full-time pre-pandemic, and 11.7% of them lost their job, while 14.2% of respondents were working part-time pre-pandemic and 19.3% of them lost their job. 22.3% of employed respondents had a decrease in income during the pandemic, with 8.5% applying for employment insurance due to loss of income. 63.5% stated they drink alcohol normally, with 27.0% increasing their weekly alcohol intake. Of the 104 persons who responded to increasing alcoholic intake, 51.9% increased their weekly alcoholic intake by 1-5 drinks, 26.0% by 6-9 drinks, and 21.2% by 10+ drinks. 13.8% used marijuana regularly, with 40.3% of these people increasing their marijuana intake during the pandemic. 56.0% of people were regularly exercising during the pandemic, with 13.3% exercising more during the pandemic, and 20.0% exercising less. Discussion Our survey shows that persons with IBD increased their alcohol and marijuana intake during the pandemic. Of persons working pre-pandemic nearly 12% (full-time workers) and nearly 20% (part-time workers) lost their job during the pandemic and nearly one quarter reported a decrease in income. While one fifth of respondents exercised less 13% exercised more. It is unknown what factors triggered an increase in maladaptive behaviors. More research is needed to understand if these behaviors continued during the pandemic and how these behaviors affected long-term outcomes in their IBD.
ABSTRACT
Introduction It is well established that persons with IBD have significantly higher rates of depression and anxiety than the general population, and that mental health symptoms exacerbate disease symptoms and impair quality of life. During the COVID pandemic, the general public has experienced escalating rates of anxiety and depression. Our aim was to determine the mental health impact of the COVID-19 pandemic on adults with IBD, focusing in this study on access to mental health resources. Methods All adults with current contact information in the population-based University of Manitoba IBD Research Registry (n=2833) were invited to participate in a survey via mail regarding their experiences with COVID-19 during autumn 2020, just prior to and during the second pandemic wave in Manitoba. The survey included background sociodemographic and disease information (e.g., symptom severity, medication use), COVID-related personal and health circumstances and coping. Results Response rate was 48.9% (n=1384). The mean age of respondents was 57.8 years, 59.3% were female and 46.9% had Crohn's disease. One in 5 (21.0%) of respondents had a prior diagnosis of a mental health condition. Overall, 11.6% felt they needed help from a mental health professional during the pandemic, with close to half (44.7%) of these individuals feeling they had inadequate access to a mental health professional. 10.0% accessed some type of resource;(of these, 52.5% used the internet, 24.5% used an app to help manage pandemic-related distress or anxiety). The most distressing aspects of the pandemic were concerns about family health (35.8%), concerns for getting infected with COVID-19 (27.2%), and having an IBD flare (9.0%). Trusted sources of information on the pandemic included television programs (64.2%), internet (46.1%), newspaper (27.8%), friends or family (21.7%), and social media (16.9%). Just over half (53.3%) spent 1-5 hours daily consuming information on COVID-19 from various sources, whereas 41.5% spent much less time (1-60 minutes/day). 51.4% tried to limit time spent watching the news or on the internet on the topic of COVID-19;of these, 9.6% found this quite or extremely difficult, and 22.1% had moderate difficulty limiting information consumption. Conclusion Mental health needs were prevalent for individuals with IBD during the first waves of the pandemic, with many of those who identified a need for professional help not feeling they had sufficient access to care. The most common mental health resource accessed was technology-based. A large proportion spent significant time focused on pandemic-related information. Further research is needed to examine changes over time during the pandemic and inter-relationships among mental health, care needs and IBD disease course.
ABSTRACT
Introduction The COVID-19 pandemic has globally impacted public health and the world economy. This has related, in part, to challenges in accessing medical care including procedures, hospitalizations and/or surgeries that would have been otherwise warranted in their disease management. Access to care was affected during the pandemic as most providers were not seeing patients in person, but providing virtual care. Patients' perceptions of their access to care may cause significant stress and anxiety, in a population in which many already have existing mental health conditions. Methods Participants in the populationbased University of Manitoba IBD Research Registry (n=2833) were invited to participate in a survey regarding their experiences with COVID-19, during autumn 2020, just prior to and during the second pandemic wave in Manitoba. The survey included background sociodemographic and disease information (e.g., symptom severity, medication use), COVIDrelated personal and health circumstances and coping. Results There were 1384 respondents (48.9%), of which 46.9% had Crohn's disease, 40.8% had ulcerative colitis, 3.2% had ulcerative proctitis, 2.8% had IBD-U and 2.2% had an ileoanal pouch. The mean age of respondents was 57.8 years, 40.6% were male. Mean duration of disease was 24.8 years. 38.3% said the pandemic was affecting them extremely, or a lot, while 15.6% said not at all or a little. 65.5% and 62.1% of respondents felt they had good access to their non-IBD provider to discuss non-IBD health care issues, and IBD issues, respectively. Only 53% felt they had good access to their gastroenterologist to discuss their IBD. 45.3% of respondents had increased stress about accessing their physician or nurse, while 19.9% had increased stress about accessing their prescription IBD medications. 901 (65.1%) patients were on some form of IBD therapy;12.5% of IBD-medication users adjusted their IBD medications on their own, while 13.8% had a provider adjust their IBD therapy. Conclusion Our survey revealed that over half of respondents did not feel they had good access to their gastroenterologist, or had increased stress associated with accessing care or their IBD medications 9-10 months into the pandemic. Some adjusted their IBD therapies on their own. Perception regarding access to care is integral for patients with IBD, and further research is needed to understand if perceptions regarding limited access to care changed and whether or not care was in fact limited as the pandemic evolved.