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P180. Impact of ulcerative colitis on patient quality of life in a real-world clinical setting

E. Louis1, A. Roughly2, R.B. Thakkar3, M. Skup3, M. Yang3, P.M. Mulani3, J. Chao3, 1University of Liège and CHU Liège, Liège, Belgium, 2Adelphi Real World, Manchester, United Kingdom, 3Abbott Laboratories, Abbott Park, IL, United States

Background

Ulcerative colitis (UC) is a chronic, often debilitating, inflammatory gastrointestinal disorder. This study utilized data from the Adelphi UC Disease Specific Program (DSP), a large, multinational, cross-sectional survey, to assess the quality of life of patients with UC in a European real-world clinical setting.

Methods

Data from patients in France, Germany, Italy, and Spain were collected from July-September 2012. The EQ-5D visual analog scale (VAS) and Work Productivity and Activity Impairment Questionnaire (WPAI) were part of the survey and captured health status and the ability to work, respectively. Additionally, patients were asked (yes/no) whether UC has had an adverse effect on various aspects of their lives (ie, education and career, social life, personal life/relationships, and outlook on life). Fisher's exact tests and analysis of variance were used to assess differences in categorical and continuous variables, respectively, among patients with current mild, moderate, and severe UC as determined by their gastroenterologist.

Results

1678 patients comprised the study sample (mean age, 40.8 years; 51% men) with a mean disease duration of 4 years; 53.9%, 39.9%, and 6.1% of patients had mild, moderate, and severe UC, respectively. Significantly more patients with moderate (53.0%) and severe (76.7%) UC experienced a flare in the previous year compared with mild UC (34.9%) (P < 0.001 for both moderate vs. mild and severe vs. moderate). Patients with moderate and severe UC also viewed their current health state as significantly worse than those with mild UC (table). Further, patients with moderate and severe UC reported at least 2–3 times greater work and activity impairment than those mild UC (table). More patients with moderate and severe disease reported experiencing adverse effects of UC on their education and career, social life, personal life and relationships, and outlook on life (table).

Table: Quality of Life outcomes by UC severity
VariableUC severityP-value
 MildModerateSevereModerate vs. MildSevere vs. Moderate
EQ-5D VAS, mean±SD74.8±16.762.3±16.346.8±21.3<0.001b<0.001b
WPAI % work time missed, mean±SD3.3±15.79.8±23.253.7±47.6<0.001b<0.001b
WPAI % impairment on the job, mean±SD14.5±15.031.6±20.546.7±18.4<0.001b0.007b
WPAI overall work impairment, mean±SD15.3±15.634.7±22.449.9±20.6<0.001b0.016b
WPAI activity impairment, mean±SD20.3±21.538.1±23.166.4±27.0<0.001b<0.001b
Has UC adversely affected your education and career? n/N (%)125/531 (23.5)100/364 (27.5)36/61 (59.0)0.184a<0.001a
Has UC adversely affected your social life? n/N (%)181/532 (34.0)165/364 (45.3)44/61 (72.1)0.001a<0.001a
Has UC adversely affected your personal life and relationships? n/N (%)174/530 (32.8)160/363 (44.1)38/61 (62.3)0.001a<0.012a
Has UC adversely affected your outlook on life? n/N (%)170/526 (32.3)175/360 (48.6)46/60 (76.7)<0.001a<0.001a
aBased on Chi-square tests. bBased on analysis of variance.

Conclusion

On the basis of data reported by patients in a real-world clinical setting, the impact of UC on a patient's quality of life was significantly greater for patients with moderate and severe UC, compared to those with mild UC.