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P105. The individual economic impact of inflammatory bowel disease; The colonic recession

M.D. Cannon, S. McKenna, D. Keegan, H. Mulcahy, G.A. Doherty

St Vincent's University Hospital, Dublin 4, Ireland

Aim: Inflammatory bowel disease (IBD) is a chronic disorder which has a significant physical and psychological impact for our patients. Although there is a growing literature on the economic impact of IBD care, there have been few studies focussing on the long term effects of IBD on individual patient finances. We aimed to assess the financial impact of IBD on those patients attending clinics in a large tertiary referral centre.

Materials and Methods: 268 consecutive patients attending IBD clinics were invited to complete a short detailed anonymous questionnaire, with questions on employment history, earnings, and finances.

Results: The overall response rate was 66% (176/268). Response rate was 71% (104/146) for those patients with Crohn's Disease, and 59% (72/122) for patients with Ulcerative Colitis (UC). 88% of patients surveyed had been in continuous employment in the year prior to being diagnosed with IBD. However, only 73% had been in continuous employment in the year prior to clinic review. (Z test, Z = 3.097, p = 0.002). 51% of these patients had one or more financial dependents. 36% of Crohn's patients, and 26% of UC patients surveyed, were not working at the time of clinic review. Of those working, 9% of UC patients had missed more than 5 days from work in the past month, compared with 25% of Crohn's patients (Z = 2.227, p = 0.026). 25% of Crohn's patients felt their form of IBD had a major effect on their ability to earn a living, compared with just 9% of UC patients (Z = 2.442, p = 0.01). 57% of all patients surveyed had difficulty paying for their medications, and 19% missed medication doses because they could not afford them.

Conclusion: The economic impact of IBD on individual patients is an area that has not previously been studied in detail. Our results show both Crohn's Disease and UC have a major impact on patients' financial situation. Although Crohn's Disease has a greater impact than UC, financial considerations have an important impact on treatment, and can result in decreased compliance with medication in both Ulcerative Colitis and Crohn's Disease.