Factors associated with changes in self-reported health status in infliximab-treated inflammatory bowel disease patients: results from a case management survey.

Background: Canadian inflammatory bowel disease patients treated with infliximab are predominantly managed through a nationwide case management system, named BioAdvance((R)). Methods: A web-based survey was provided to patients currently receiving infliximab therapy within BioAdvance((R)). Patients were categorized according to health trajectories: decliners, non-changers, moderate increasers and strong increasers. Factors associated with health trajectories were identified using multivariable multinomial logistic regression. Results: 918 of 1160 respondents were inflammatory bowel disease patients reporting health status. Strong increasers were more likely to use educational tools than non-changers (adjusted odds ratio [aOR]: 1.65; 95% CI: 1.03-2.64), to be treated for ulcerative colitis (aOR: 2.05; 95% CI: 1.16-3.64) and to perceive case management as important (aOR: 2.52; 95% CI: 1.56-4.09). Younger (aOR: 0.72; 95% CI: 0.63-0.83) and French-speaking (aOR: 0.34; 95% CI: 0.18-0.63) patients were less likely to miss workdays. Patients were more likely to have missed workdays prior to joining the case management program. Conclusions: Inflammatory bowel disease patients receiving infliximab within the nationwide case management system report a positive impact on health status and absenteeism.