S968 Attitudes and Adherence to Inflammatory Bowel Disease (IBD) Medications in a Racially and Ethnically Diverse Population

Abstract

Introduction: Racial and ethnic differences in attitudes towards IBD medications, adherence and persistence is not well studied. Studies in other chronic diseases suggest lower levels of trust and adherence to medication in people of color. This survey evaluated attitudes toward IBD medications and self-reported adherence of a diverse patient population in a large US health system. Methods: A survey was created with input from a racially and ethnically diverse panel of patients with IBD. Following institutional review board (IRB) approval, the survey was sent electronically once to adult patients with IBD treated in the health system from Aug 2019 through Dec 2021. Surveys were anonymous. Data collected included demographics, access to care via the Consumer Assessment of Healthcare Providers and Systems, and Barriers to Care surveys, the Medication Adherence Rating Scale-4 (MARS-4), and the Beliefs about Medicines Questionnaire. Analyses compared White/Non-Hispanics (W/NH) and Black/Indigenous/People of Color or Hispanics (BIPOC/H) via X2 and t-tests. Results: The survey was sent to 1,210 patients once, 171 responded (14%); 103 (60%) W/NH, and 68 BIPOC/H (40%). Demographic information is shown in Table. BIPOC/H patients reported more concerns regarding long term effects of IBD medications than W/NH counterparts (40% vs 27%; p=.02), were more likely to be worried about becoming dependent on IBD medications (35% vs 19%; p=.041) and were more uncertain of the toxicities of IBD medications (32% vs 15%; p=.007). Both BIPOC/H and W/NH patients reported difficulties accessing medications (40% vs 42%; p >.05). There was a trend toward BIPOC/H patients reporting more non-adherence via the MARS-4 (38% vs 26%) (p=.08). BIPOC/H patients also reported a trend towards intentionally missed doses 40% vs 28% of W/NH (p=.09). The same proportion of BIPOC/H and W/NH patients reported declining to start a newly prescribed medication altogether in the last 6 months (8%) and not persisting on a medication (9%). Conclusion: BIPOC/H patients with IBD report more concerns about long term use and toxicities of IBD medications than W/NHs. Both self-report similar medication access, adherence, and persistence. Future studies are needed to understand the causes of their concerns for long-term use and toxicities, and the potential impact on outcomes. Table 1. - Demographics W/NH n = 103 BIPOC/H n = 68 p Age, Mean (SD) 48.7 (14) 44.0 (13.3) .03 Female gender, n( %) 71 (69) 48 (71) .87 Male gender, n (%) 32 (31) 20 (29) Highest level of education, n (%) High school graduate or less 20 (20) 17 (25) .11 Some college or 2-year degree 29 (28) 24 (35) 4-year college graduate 23 (22) 9 (13) More than 4-year college degree 31 (30) 14 (21) Marital Status, n (%) Single 30 (29) 30 (44) .12 Married/domestic partnership 54 (52) 25 (37) Widowed 15 (14) 12 (18) Separated/divorced 4 (3) 1 (2) Types of Health Insurance, n (%) HMO/PPO/Private Insurance 66 (64) 28 (41) .001 Medicare 21 (20) 18 (27) Medicaid 19 (18) 29 (43) No insurance/self-pay 3 (2.9) 0 (0.0)