S564 Burden of Disease in U.S. Patients With Irritable Bowel Syndrome With Diarrhea (IBS-D)

Abstract

Introduction: Symptoms of irritable bowel syndrome with diarrhea (IBS-D) impose a significant burden to patients. Our study examined disease burden and care-seeking behavior of patients with IBS-D. Methods: A cross-sectional, on-line health survey collected data during 8/2020-12/2021 from US adults. IBS-D patients were defined using Rome IV criteria. Health outcomes comparing IBS-D patients to controls included anxiety and depression screeners, health-related quality of life (HRQoL) and productivity measures. Care, treatment and symptom burden were assessed for IBS-D patients. Differences in anxiety, depression, HRQoL, and productivity between IBS-D patients and the general population were assessed with a 1:1 matched sample by sex, age, race, region and Charlson Comorbidity Index score. Categorical data were described by percentage and continuous data by mean and standard deviation. Means were compared with ANOVA and proportions with chi-square tests. Results: Data was collected from 29,359 participants. Matching IBS-D participants resulted in 669 patients and 669 controls. Most patients were female (74.6%), White (84.0%), with a mean age of 41.9 years. IBS-D patients had significantly higher proportions of moderate to severe anxiety and depression (p < .001) and significantly lower HRQoL vs controls (p < .001). Health impact on work productivity and daily activity was significantly higher among IBS-D patients vs controls (Table). Of IBS-D patients, 91.5% sought care for their symptoms, 59.3% within the past year. Of those having an ER visit/hospitalization in the past year (17.3%), abdominal pain was the most reported reason (87.1%). 65.9% of IBS-D patients reported currently taking an Rx and/or an OTC for their symptoms (13.2% Rx alone, 13.9% Rx and OTC, and 38.9% OTC alone). Abdominal pain and abdominal discomfort were the symptoms most experienced (71.0% and 70.9%, respectively). Abdominal pain was reported to be the most bothersome (34.5%) (Figure). IBS-D patients currently taking an Rx with/without an OTC were more satisfied with the control of bowel (39.2% vs 21.5%) and abdominal (40.3% vs 22.7%) symptoms than those currently taking an OTC alone. Conclusion: This large survey study demonstrates that the health impact of IBS-D is high. Nearly 1 in 5 patients sought care at an ER for their symptoms. Abdominal pain and discomfort are common bothersome symptoms with patients reporting better control with Rx medications compared to OTC agents.Figure 1.: Symptom Experience, Frequency and Bothersomeness Table 1. - Characteristics of the Rome IV IBS-D Cohort vs Controls (1) WPAI fielded 12/20-12/21: Rome IV IBS-D cohort n=463; control n=397. (2) GAD-7: Generalized Anxiety Disorder, 7-item; range: 0-21. (3) PHQ-9: Patient Health Questionnaire, 9-item; range: 0-29. (4) Veterans RAND 12-item Health Survey (VR12). (5) Question fielded 12/20-12/21: Rome IV IBS-D cohort n=251; control n=233 Rome IV IBS-D Cohort(N=669) Control(N=669) Sig. Female 74.6% 74.6% 1.000 Age, mean (SD) 41.9 (15.0) 41.9 (15.0) 0.990 Black or African American 7.8% 7.8% 1.000 White 84.0% 84.0% Other 8.2% 8.2% Proportion of Hispanic, Latino or Spanish origin 7.8% 8.5% 0.617 Northeast 17.2% 17.2% 1.000 Midwest 22.6% 22.6% South 42.8% 42.8% West 17.5% 17.5% Charlson Comorbidity Index (CCI) score, mean (SD) 0.6 (1.1) 0.6 (1.1) 1.000 Body Mass Index (BMI) (lbs/in2), mean (SD) 30.2 (9.0) 27.9 (7.4) < 0.001 Proportion employed per Work Productivity and Impairment (WPAI) (1) 54.2% 58.7% 0.187 Median household income (Census derived from zip code), mean (SD) 65,468(28,360) 65,459(26,647) 0.996 Anxiety (GAD-7 [2]) score, mean (SD) 9.9 (6.1) 6.8 (5.8) < 0.001 Depression (PHQ-9 [3]) score, mean (SD) 11.4 (7.3) 7.9 (7.1) < 0.001 Chronic pain 61.4% 38.6% < 0.001 Migraine 64.2% 35.8% < 0.001 Insomnia 67.7% 32.3% < 0.001 GERD 75.9% 24.1% < 0.001 VR-12 Mental Component Summary (MCS [4]), mean (SD) 36.7 (12.5) 43.9 (11.8) < 0.001 VR-12 Physical Component Summary (PCS [4]), mean (SD) 40.3 (11.2) 44.4 (10.6) < 0.001 VR-12 Health utility (VR-6D [4]), mean (SD) 0.60 (0.11) 0.67 (.12) < 0.001 Health problems affected work productivity rating (0-10 scale), mean, SD (5) 3.1 (2.9) 2.1 (2.8) < 0.001 Health problems affected daily activities rating (0-10 scale), mean, SD (1) 4.3 (3.2) 2.6 (3.1) < 0.001