Black/African American Patients with Pediatric Crohn's Disease Report Less Anxiety and Fatigue than White Patients

Abstract

To compare patient-reported outcomes in black/African American patients with white patients participating in IBD Partners Kids & Teens, in order to identify possible racial healthcare disparities in pediatric inflammatory bowel disease (IBD) as future targets for improvement. This was a cross-sectional analysis comparing patient-reported outcomes in black/African American patients with white patients, aged 9-18years, with IBD participating in the IBD Partners Kids & Teens cohort from August 2013 to April 2018. Secondary outcomes included number of IBD-related hospitalizations and surgeries, current medication use, and disease activity. We included 401 patients with Crohn's disease (white=378 [94%]; black/African American=23 [6%]). For children with Crohn's disease, black/African American patients compared with white patients reported less anxiety (40.7 vs 47.5, P=.001) and fatigue (44.3 vs 48.4, P=.047) despite more frequently reported treatment with biologics (91% vs 61%, P=.006) and antibiotics (17% vs 5%, P=.03) and history of hospitalizations (81% vs 52%, P=.02). Black/African American children with Crohn's disease were less likely to report anxiety or fatigue than white patients, despite an apparent more severe disease course reflected by greater reported frequency of treatment with biologics and antibiotics and history of hospitalizations.