P071 Quality of life of patients treated in an Inflammatory Bowel Disease Program in Chile

Abstract

BACKGROUND: Inflammatory Bowel Disease impacts patient's quality of life (QoL). Its chronic nature, flares, extraintestinal manifestations, the risk of surgery and cancer, affects their QoL, however, the results depends on each population. The aim of this study was to determine QoL of patients treated in an Inflammatory Bowel Disease Program in Chile. METHODS: A descriptive, cross-sectional study was performed between March and July 2018. All patients with Crohn’s Disease (CD) or Ulcerative Colitis (UC) who attended a medical consultation in the IBD Program were evaluated for QoL with the shortened Spanish version of the IBDQ. The IBDQ-9 survey consists of 9 items assessing different aspects of life in IBD patients. Each question has 7 different possible answers, scoring from 1 (poorest) to 7 (best). Higher scores correspond to a better QoL. IBD clinical variables, clinical disease activity and fecal calprotectin were also evaluated in the medical consultation. Patients with a Harvey-Bradshaw score >4 for CD and a Mayo Subscore >2 for UC, and fecal calprotectin >250 μg/g were considered with active disease. Statistical analysis was performed using frequency, medians and Mann Whitney test (P < 0.05). RESULTS: During the study period 1,051 medical consultations were performed, assessing QoL in 457 patients; 78 in their first visit in the IBD Program (17%) and 379 follow-up patients (83%). Demographic and clinical variables were: 60% female, median age 35 years (r: 15–88), 326 patients with UC (71%) and 131 with CD (29%), median duration of disease 5 years (r: 0–43), 224 with extraintestinal manifestations (49%). Related to disease activity, 45% were clinically active. From all patients, fecal calprotectin was determined concomitant to the medical consultation in 264 patients (58%), 118 of them with fecal calprotectin >250 μg/g (45%). Of all patients, 4% showed low QoL, 41% medium and 58% high. The median of QoL was lower in patients consulting for the first time in the IBD Program than patients in regular follow-up (38 vs 46; P = 0.005). Patients with active disease showed statistically significant lower QoL than patients in remission, in both groups (33 vs 41; P = 0.002 in the first visit and 35 vs 47; P < 0.0001 in follow-up patients). In addition, in the follow-up group, female gender, CD, presence of extraintestinal manifestations, fecal calprotectin >250 μg/g and not being treated with biological therapy, were significantly associated with lower QoL. CONCLUSION(S): A high percentage of patients with IBD refers a low or medium QoL (45%), even more in severe patients. The QoL should be evaluated as an integral part of the management of patients with IBD, considering that the improve of patient’s perception of QoL is one of the goals of the treatment in IBD.