Ingunn Johansen

• Strande, Vibeke; Lund, Charlotte; Hagen, Milada; Bengtson, May-Bente; Boyar Cetinkaya, Raziye & Detlie, Trond Espen [Show all 23 contributors for this article] (2024). Clinical course of ulcerative colitis: Frequent use of biologics and low colectomy rate first year after diagnosis—results from the IBSEN III inception cohort. Alimentary Pharmacology and Therapeutics. ISSN 0269-2813. doi: 10.1111/apt.18097. Show summary

  Background: The introduction of biologic therapies and the 'treat-to-target' treatment strategy may have changed the disease course of ulcerative colitis (UC). Aims: To describe the early disease course and disease outcome at 1-year follow-up in a population-based inception cohort of adult patients with newly diagnosed UC. Methods: The Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III study is a population-based inception cohort study with prospective follow-up. Patients newly diagnosed with inflammatory bowel disease during 2017-2019 were included. Patients ≥18 years at diagnosis of UC who attended the 1-year follow-up were investigated. We registered clinical, endoscopic and demographic data at diagnosis and 1-year follow-up. Results: We included 877 patients with UC (median age 36 years (range: 18-84), 45.8% female). At diagnosis, 39.2% presented with proctitis, 24.7% left-sided colitis and 36.0% extensive colitis. At the 1-year follow-up, 13.9% experienced disease progression, and 14.5% had received one or more biologic therapies. The colectomy rate was 0.9%. Steroid-free clinical remission was observed in 76.6%, and steroid-free endoscopic remission in 68.7%. Anaemia and initiation of systemic steroid treatment at diagnosis were associated with biologic therapy within the first year after diagnosis. Conclusion: In this population-based inception cohort, colectomy rate in the first year after diagnosis was low, and a high proportion of patients were in remission at 1-year follow-up. The use of biologic therapy increases, consistent with findings from previous studies.

• Zerouga, Insaf; Valeur, Jørgen; Sommer, Christine; Småstuen, Milada Cvancarova; Medhus, Asle Wilhelm & Lund, Charlotte [Show all 22 contributors for this article] (2024). Dietary intake and nutritional status in patients with newly diagnosed inflammatory bowel disease: insights from the IBSEN III study. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. p. 1–9. doi: 10.1080/00365521.2024.2313056. Show summary

  Background: Dietary recommendations in inflammatory bowel disease (IBD) are inconclusive, and patients may follow restrictive diets with increased risk of malnutrition. The aim of this study was to compare dietary intakes and nutritional status in men and women with newly diagnosed IBD with a general population sample, and to investigate whether intakes were in line with the Nordic Nutrition Recommendations. Methods: This was a cross-sectional study including adults≥ 40 years with IBD from the Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III cohort study. A validated food frequency questionnaire (FFQ) was used in dietary data collection, and a sample from the seventh survey of the Tromsø Study was included as a comparison group. Results: A total of 227 men and women with IBD were included. IBD patients had higher intake of grain products, sweetened beverages, energy, fat and polyunsaturated fat (PUFA), but lower intake of dairy products, alcohol and iodine compared to adults from the comparison sample (p < 0.01). Intakes of saturated fat and carbohydrates in both genders, and vitamin D in women were not within recommended levels. Anemia and hypoalbuminemia were more prevalent in IBD patients than in the comparison sample. Conclusions: Dietary intakes in newly diagnosed IBD patients were mostly in line with Nordic Nutrition Recommendations. Higher proportion of IBD patients exceeded recommended allowances of fat and added sugar than the comparison sample. Insufficient micronutrient intake, anemia and hypoalbuminemia are present challenges in IBD patients that require monitoring.

• Johansen, Ingunn; Småstuen, Milada Cvancarova; Løkkeberg, Stine Eileen Torp; Kristensen, Vendel Ailin; Høivik, Marte Lie & Lund, Charlotte [Show all 16 contributors for this article] (2023). Symptoms and symptom clusters in patients newly diagnosed with inflammatory bowel disease: results from the IBSEN III Study. BMC Gastroenterology. ISSN 1471-230X. 23(1). doi: 10.1186/s12876-023-02889-y. Full text in Research Archive Show summary

  Patients with inflammatory bowel disease report multiple symptoms, but the relationships among co-occurring symptoms are poorly understood. This study aimed to examine the prevalence of symptoms and explore symptom clusters and possible associations between symptom clusters and socio-demographic and clinical variables in patients newly diagnosed with inflammatory bowel disease. Methods The IBSEN III study is a prospective population-based inception cohort of patients with inflammatory bowel disease. This study used patient data from the three largest hospitals in the study catchment area. The Memorial Symptom Assessment Scale was used to assess the prevalence of symptoms. Symptom clusters were identified using principal component analysis. Possible associations between socio-demographic and clinical variables and symptom cluster membership were estimated using regression analysis. Results Of the 573 patients (age, ≥18 years) diagnosed with inflammatory bowel disease, 350 (61.1%) completed the questionnaire (responders). Eleven symptoms were reported by >50% of the responders. The three most prevalent symptoms were bloating (84%), drowsiness (81%), and lack of energy (81%). Three symptom clusters were identified: psychological (56% of the patients), impaired energy (28%), and physical (16%) clusters. Multinomial regression analysis revealed that vitamin D deficiency was significantly associated with the impaired energy cluster (odds ratio=2.49, 95% confidence interval [1.00-6.2], p=0.05). Conclusions We found high symptom prevalence in patients newly diagnosed with inflammatory bowel disease. Three distinct symptom clusters were identified, and the psychological cluster includes >50% of the patients. Vitamin D deficiency is the only factor associated with cluster membership, namely the impaired energy cluster.

• Holten, Kristina Ingeborg; Bernklev, Tomm; Opheim, Randi; Johansen, Ingunn; Olsen, Bjørn Christian Elias Grova & Lund, Charlotte [Show all 22 contributors for this article] (2023). Fatigue in Patients with Newly Diagnosed Inflammatory Bowel Disease: Results from a Prospective Inception Cohort, the IBSEN III Study. Journal of Crohn's and Colitis. ISSN 1873-9946. 17(11), p. 1781–1790. doi: 10.1093/ecco-jcc/jjad094. Full text in Research Archive
• Olsen, Bjørn Christian Elias Grova; Opheim, Randi; Høivik, Marte Lie; Lund, Charlotte; Aabrekk, Tone Bergene & Johansen, Ingunn [Show all 15 contributors for this article] (2023). Health-related quality of life in patients with newly diagnosed inflammatory bowel disease: an observational prospective cohort study (IBSEN III). Quality of Life Research. ISSN 0962-9343. 32(10), p. 2951–2964. doi: 10.1007/s11136-023-03435-9. Full text in Research Archive
• Kristensen, Vendel Ailin; Opheim, Randi; Perminow, Gøri Margrete; Huppertz-Hauss, Gert; Detlie, Trond Espen & Lund, Charlotte [Show all 39 contributors for this article] (2021). Inflammatory bowel disease in South-Eastern Norway III (IBSEN III): a new population-based inception cohort study from South-Eastern Norway. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 56(8), p. 899–905. doi: 10.1080/00365521.2021.1922746. Full text in Research Archive Show summary

  Background and aim: Modern treatment strategies for inflammatory bowel disease (IBD) are postulated to change the natural disease course. Inception cohort studies are the gold standard for investigating such changes. We have initiated a new population-based inception cohort study; Inflammatory bowel disease in South Eastern Norway III (IBSEN III). In this article, we describe the study protocol and baseline characteristics of the cohort. Methods: IBSEN III is an ongoing, population-based observational inception cohort study with prospective follow-up. Adult and pediatric patients with suspected IBD in the South-Eastern Health Region of Norway (catchment area of 2.95 million inhabitants in 2017), during the 3-year period from 2017 to 2019, were eligible for inclusion. Comprehensive clinical, biochemical, endoscopic, demographic, and patient-reported data were collected at the time of diagnosis and throughout standardized follow-up. For a portion of the patients, extensive biological material was biobanked. Results: The study included 2168 patients, of whom 1779 were diagnosed with IBD (Crohn's disease: 626, ulcerative colitis: 1082, IBD unclassified: 71). In 124 patients, there were subtle findings indicative of, but not diagnostic for, IBD. The remaining 265 patients were classified as symptomatic non-IBD controls. Conclusion: We have included patients in a comprehensive population-based IBD cohort from a catchment population of 2.95 million, and a unique biobank with materials from newly diagnosed and treatment-naïve IBD patients and symptomatic non-IBD controls. We believe this cohort will add important knowledge about IBD in the years to come.

• Berger, Ola; Sand, Kari; Johansen, Ingunn; Loge, Jon Håvard; Kaasa, Stein & Grønberg, Bjørn H. (2014). What Do Cancer Patients and Members of Ethical Review Boards in Norway Consider Important Elements of Informed Consent Documents? AJOB Empirical Bioethics. ISSN 2329-4515. 5(4), p. 1–13. doi: 10.1080/23294515.2014.938199. Show summary

  Background: The length and content of informed consent documents (ICDs) in clinical trials have increased in recent decades. In Norway, Regional Committees for Medical and Health Research Ethics (RECs) approve ICDs according to national and international guidelines. The aim of this study was to investigate how important members of these committees and cancer patients consider the information elements found in ICDs to be. Methods: Using the Delphi technique, an expert group developed a questionnaire for asking the participants how they rated the importance of 31 information elements, and whether they were familiar with or considered seven terms/phrases commonly used in ICDs difficult to understand. All 123 members of the Norwegian RECs and 200 consecutive cancer patients at the outpatient cancer clinic at St. Olavs Hospital, Trondheim University Hospital, received the questionnaire. Group comparisons were conducted using chi-squared and Fisher`s exact tests. The statistical significance level was defined as p < .01 due to multiple comparisons. Results: The committee members (n = 81) and patients (n = 104) rated almost all (95%) of the information elements as important. Very few (4%) information elements were rated as not important. We did not find any significant differences in the rating of the elements between subgroups of patients, between subgroups of REC members, or between patients and REC members. The patients were not familiar with all terms commonly found in ICDs, and the REC members were not able to predict which terms the patients were familiar with. Patients rated the information elements as more important if they were familiar with the terms used in the respective elements. Conclusions: The participants rated almost all information elements important to include in ICDs, suggesting that ICDs cannot necessarily be shortened by leaving out information elements. Ensuring that patients understand all terms in an ICD appears to be a particularly important part of the informed consent process.

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• Kristensen, Vendel; Olsen, Bjørn & Johansen, Ingunn (2023). IBSEN III-studien – femårskontrollen er i gang. Fordøyelsen. ISSN 0808-4297.
• Johansen, Ingunn; Småstuen, Milada Cvancarova; Løkkeberg, Stine Eileen Torp; Kristensen, Vendel Ailin; Høivik, Marte Lie & Lund, Charlotte [Show all 16 contributors for this article] (2022). Symptoms and symptom clusters in patients newly diagnosed with inflammtory bowel disease – results from the IBSEN III study .
• Johansen, Ingunn (2019). Symptombyrde, livskvalitet og sykefravær. Fordøyelsen. Tidsskrift for landsforeningen mot fordøyelsessykdommer.
• Johansen, Ingunn (2019). IBSEN III: Symptom burden in patients with inflammatory bowel disease - impact on health-related quality of life and sick leave.
• Ekman, Stina; Fladeby, Nina; Johansen, Ingunn; Hardeland, Camilla & Leonardsen, Ann-Chatrin Linqvist (2019). Hvordan kan sykepleierstudenter få det bedre i praksis? Tidsskriftet sykepleien. ISSN 0806-7511. doi: 10.4220/Sykepleiens.2019.74902.
• Berger, Ola; Sand, Kari; Johansen, Ingunn; Kaasa, Stein; Loge, Jon Håvard & Grønberg, Bjørn Henning (2014). What Do Cancer Patients and Members of Ethical Review Boards in Norway Consider Important Elements in Informed Consent Documents?
• Berger, Ola; Sand, Kari; Johansen, Ingunn; Loge, Jon Håvard; Kaasa, Stein & Grønberg, Bjørn Henning (2014). What Do Cancer Patients and Members of Ethical Review Boards in Norway Consider Important Elements in Informed Consent Documents? Palliative Medicine. ISSN 0269-2163. 28(6). doi: 10.1177/0269216314532748.

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