Table 2.
Summary of data extracted from the reviewed literature (in ascending chronological order)
| Study | Year | Geographic location | Study design | Sample size and characteristics | Disease activity | Fatigue questionnaires and measurements | HRQoL questionnaires and measurements | Study findings | Quality |
| Castillo-Cejas, et al 39 | 2013 | Spain | Cross-sectional | Two-part study: part 1/99 (55 CD, 44 UC); part 2/137 (70 CD, 67 UC) | Active CD; 49%. Active UC; 46% | DFIS, FSS, MFI | EQ-5D-5L, IBDQ-9 | High levels of disease activity related to high levels of fatigue. High levels of fatigue related to low HRQoL. | High |
| Czuber-Dochan, et al 7 | 2013 | UK | Qualitative | 46 (28 CD, 18 UC) selected from online database | Not disclosed | No questionnaires used, focus group study | Five themes identified: experience, causes, management, consequences and seeking support. Participants described fatigue in terms of how it affected life. High levels of fatigue affected physical and cognitive abilities, impacting on everyday life. | High | |
| Viazis, N. et al 32 | 2013 | Greece | Qualitative | 1181 (827 online questionnaire, 354 outpatient clinic questionnaires) (642 CD, 539 UC) | Not disclosed | Survey of authors’ own design (unvalidated) | 60% of patients felt depressed, 25% felt angry because of IBD fatigue. IBD fatigue interfered with social life in more than half of cases also affecting working capability. Respondents report good social support from family and friends. | Low | |
| Cohen, B. L. et al 35 | 2014 | USA | Prevalence | 220 (125 CD, 95 UC) from disease registry | Active CD; fatigued 44%, non-fatigued 18%. Active UC; fatigued 38%, non-fatigued 22% | FACIT-F scale | SF-36, EuroQoL EQ-5D-5L, IBDQ-32 | Patients with fatigue reported having problems with their usual daily activities, except for self-care. The association of fatigue and impairment were strongest for usual activities. Patients with fatigue had worse valuations of current health status. | High |
| Devlen, J. et al 33 | 2014 | USA | Qualitative | 27 participants (four focus groups), 10 1:1 interviews) (21 UC, 6 CD) | Active disease; 22% (CD/UC not specified) | No questionnaires used, focus group study | 21/27 participants were in disease remission. Patient reported key burdens of IBD fatigue were impact on lifestyle, impact on daily activities, impact on relationships and psychological impact. | Medium | |
| Opheim, R. et al 38 | 2014 | Norway | Cross-sectional | 428 (238 CD, 190 UC) adult IBD outpatients | Active CD; fatigued 73% non-fatigued 45%. Active UC; fatigued 85%, non-fatgued 58% | FSS | Nil | 43% CD and 33% UC reported severe fatigue, 39% reported fatigue severely interfered with daily life. Those with higher education status, working and higher income were less likely to report high fatigue interference. 43% CD and 33% UC reported severe fatigue interference with everyday life. | Medium |
| Van Langenberg, D.R. and Gibson, P.R.8 | 2014 | Australia | Cross-sectional | 379 (181 CD, 113 UC, 85 controls) | Active disease: CD 51%, CD follow-up group 47%, UC 67% | FIS | Nil | Patients with IBD reported significantly higher scores on all global and dimensional fatigue indices compared with controls. Improved physical fatigue was associated with establishing a regular exercise routine. Improvement was seen in cognitive fatigue when immunomodulator therapy ceased. | High |
| Artom, M. et al 40 | 2017 | UK | Cross-sectional | 182 (116 CD, 60 UC) from tertiary care | Those without stoma—active disease 26%, remission 74% (CD/UC not specified) | MFI, IBD-F | IBDQ-32 | There was a significant difference in fatigue and HRQoL according to employment, education, marital and smoking status. Negative fatigue perceptions, 'all-or-nothing' and avoidance behaviours were significantly associated with worse HRQoL. | High |
| Habibi, F. et al 41 | 2017 | Iran | Cross-sectional | 71 (46 UC, 25 CD) | Those with severe disease omitted. Further disease activity data not given | Nil | IBDQ-32 | 44% of sample reported poor sleep quality, linked to daytime sleepiness and fatigue which decreases HRQoL. Higher fatigue level correlated with poorer HRQoL. | Medium |
| Skrautvol, K. and Naden, D34 | 2017 | Norway | Qualitative | 13 (7 CD, 6 UC) | Not disclosed | No questionnaires used, face-to-face interview study | Participants reported tolerance limits might be reflected in a lack of energy. Participants reported the importance of balancing regular physical activity with regular rest. | Medium | |
| Villoria, A. et al 36 | 2017 | Spain | Prevalence | 177 (127 CD, 50 UC) | Not disclosed | FACIT-F scale | IBDQ-9 | Patients with fatigue had higher scores for depression, sleep disturbance and anxiety than those without fatigue. A strong negative correlation was seen between HRQoL and fatigue. Those patients with more severe IBD fatigue had worse anxiety and depression and worse quality of life. | Medium |
CD, Crohn's disease; DFIS, Daily Fatigue Impact Scale; EQ-5D-5L, EuroQual 5-dimension questionnaire (five level); FACIT-F scale, Functional Assessment of Chronic Illness Therapy-Fatigue; FSS, Fatigue Severity Scale; IBD, inflammatory bowel disease; IBD-F, Inflammatory Bowel Disease-Fatigue scale; IBDQ-9/IBDQ-32, Inflammatory Bowel Disease Questionnaire 9(shortened)/32; MFI, multidimensional fatigue inventory; SF-36, 36-item Short Form survey; UC, ulcerative colitis.