S567 Disease Burden and Care-Seeking Behavior of Patients With Irritable Bowel Syndrome With Constipation (IBS-C) in the United States

Abstract

Introduction: Symptoms of IBS-C impose a significant negative burden to patients and the healthcare system. Our study examined disease burden and care-seeking behavior of patients with IBS-C. Methods: A cross-sectional, on-line health survey collected data on US adults from 8/2020-12/2021. IBS-C patients were defined using Rome IV criteria and matched 1:1 by sex, age, race, region and Charlson Comorbidity Index score to the general population. Outcomes comparing IBS-C patients to controls included an anxiety/depression screener, health-related quality of life (HRQoL) and productivity. Means were compared with ANOVA; proportions with chi-square tests. Endpoints assessed descriptively for IBS-C patients were care, treatment, symptom burden and satisfaction with control, health care provider management, and treatment. Results: Of 29,359 participants, 3.3% (956) met Rome IV criteria for IBS-C. Matching resulted in 910 patients and 910 controls. Most patients were female (76.9%), White (82.2%), with a mean age of 41.2 years. IBS-C 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 worse among IBS-C patients vs controls (Table). Of IBS-C patients, 92.4% sought medical care for symptoms; 59.6% within the past year. 97.3% of IBS-C patients experienced ≥1 symptoms in the past 7 days. Abdominal discomfort was the symptom most experienced (71.0%); abdominal pain was the most bothersome (34.0%). Of the IBS-C patients that visited an ER or were hospitalized in the past 12-months due to bowel movement or abdominal symptoms, abdominal pain was the most common reason (90%). 74.2% reported currently taking an Rx and/or an OTC for their symptoms (12.6% Rx alone, 14.7% Rx and OTC, and 46.8% OTC alone). IBS-C patients were more dissatisfied than satisfied with control of bowel (47.4% vs 27.3%) and abdominal (45.9% vs 27.8%) symptoms. Those currently taking an Rx with or without an OTC were more satisfied with the control of bowel (42.6% vs 22.5%) and abdominal (46.6% vs 20.9%) symptoms than those taking only an OTC (Figure). Conclusion: New data from a large survey study demonstrates that there remains a considerable disease burden and unmet need for IBS-C patients, many of whom commonly experience pain and discomfort and are dissatisfied with their symptom control. This highlights the need to better address the multiple symptoms of IBS-C.Figure 1.: Satisfaction with Control, HCP Management and Treatment Table 1. - Rome IV IBS-C Cohort vs Control Comparisons (1) Question fielded 12/20-12/21; cohort n=687 and control n=556. (2) GAD-7: Generalized Anxiety Disorder, 7-item; range: 0-21. (3) PHQ-9: Patient Health Questionnaire, 9-item; range 0-29. (4) Question fielded 12/20-12/21; cohort n=387 and control n=340 Rome IV IBS-C Cohort (N=910) Control(N=910) Sig. Female 76.9% 76.9% 1.000 Age, mean (SD) 41.2 (14.9) 41.2 (14.9) 0.995 Black or African American 9.3% 9.3% 1.000 White 82.2% 82.2% Other 8.5% 8.5% Proportion of Hispanic, Latino or Spanish origin 8.6% 10.2% 0.296 Northeast 16.5% 16.5% 1.000 Midwest 24.7% 24.7% South 39.7% 39.7% West 19.1% 19.1% Charlson Comorbidity Index (CCI) score, mean (SD) 0.5 (1.0) 0.5 (1.0) 1.000 Body Mass Index (BMI) (lbs/in2), mean (SD) 27.2 (7.3) 28.0 (7.3) 0.033 Proportion employed per Work Productivity and Impairment (WPAI) (1) 56.3% 61.2% 0.086 Proportion educated more than high school 75.5% 72.2% 0.110 Mean household income (Census derived from zip code), mean (SD) 64,553(26,853) 64,629(25,910) 0.951 Anxiety (GAD-7)[2]) score, mean (SD) 9.1 (6.1) 6.6 (6.0) < 0.001 Depression (PHQ-9 [3]) score, mean (SD) 10.9 (7.3) 7.9 (7.4) < 0.001 Chronic Pain 60.4% 39.6% < 0.001 Migraine 60.2% 39.8% < 0.001 Insomnia 67.1% 32.9% < 0.001 GERD 74.6% 25.4% < 0.001 VR-12 Mental Component Summary (MCS), mean (SD) 38.0 (12.5) 44.5 (12.2) < 0.001 VR-12 Physical Component Summary (PCS), mean (SD) 41.2 (10.7) 45.6 (10.3) < 0.001 VR-12 Health utility (VR-6D), mean (SD) 0.61 (0.11) 0.68 (0.12) < 0.001 Health problems affected work productivity rating (0-10 scale), mean, SD (4) 2.8 (2.7) 1.8 (2.8) < 0.001 Health problems affected daily activities rating (0-10 scale), mean, SD (1) 3.8 (3.1) 2.4 (3.1) < 0.001