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P174. Ulcerative colitis experience and management across countries: An international survey of patients and physicians

D. Solomon1, D. Holley2, M. Buch2, N. Pym3, K. Paridaens4

1Shire Development Inc., Wayne, PA, United States; 2GfK HealthCare, London, United Kingdom; 3Consultant, Shire Pharmaceuticals Ltd, Basingstoke, United Kingdom; 4Shire AG, Eysins, Switzerland

Background: National differences in ulcerative colitis (UC) experience and management were explored in a Web-based survey administered to patients with UC and physicians actively treating UC.

Methods: Participants from Canada, France, Germany, Ireland, Spain, and the United Kingdom were recruited from patient and physician access panels or custom “phone-to-Web” recruitment; patients and physicians were not necessarily linked. Patient organizations/advocacy groups were not used for sourcing UC patients.

Results: The survey was completed by 775 patients and 475 physicians. Patients' self-ratings of UC severity varied: severe cases ranged from 4% (Spain) to 36% (Ireland); mild cases ranged from 16% (Ireland) to 45% (Spain). Despite reporting the most severe cases, Irish patients were least likely to schedule regular doctor visits (14%; P < 0.05) and more likely to keep information from their doctor (46%; P < 0.05) vs patients in any other country. Compared with physicians in other nations, those in Spain estimated the fewest severe UC cases (9%) and most mild cases (63%) among their caseloads. The number of patient-reported flares/year was lowest in Ireland (2.5) and highest in France (8.0). More than 69% of patients in all countries except Spain (29%) considered their flare frequency to be “normal.” The highest percentage of patients who defined remission as experiencing no symptoms was in Spain (65%; P < 0.05 vs any other country); in Canada, Germany, Ireland, and the United Kingdom, the majority defined remission as living with some symptoms. Within each country, more patients (45%-69%) viewed their symptoms as affecting quality of life (QoL) compared with physician estimates (29%-45%); this difference was largest in France (69% vs 34%). Of those on 5‑aminosalicylic acid (5-ASA) therapy, Canadians most frequently reported (99%) being “very” or “somewhat” satisfied with the treatment. While Spanish patients were most likely to be fully adherent (91%), they also were most frequently “not very” or “not at all” satisfied (42%) with 5‑ASA therapy.

Conclusions: Key differences regarding patients' experiences and physicians' perceptions of UC were observed between countries. Spanish patients reported the highest expectations of UC control, Irish patients were least likely to consult with their doctor, and Canadian patients were most satisfied with 5‑ASA therapy. Across all nations, physicians underestimated the affect of UC symptoms on patient QoL.