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P410. Physician-initiated treatment patterns of ulcerative colitis patients in the United Kingdom: a review of chart-abstracted data

L. Yen1, B.J. Katic1, 1Shire Development LLC, Wayne, PA, United States

Background

Various treatment options exist for managing ulcerative colitis (UC) in the United Kingdom (UK). Relapse-associated treatment patterns, and the degree to which treatment options differ by physician specialty, however, have not been studied. This study aimed to describe common relapse-related treatment patterns for UC, both overall and by physician specialty.

Methods

A retrospective chart review of UC patients diagnosed at least 1 year prior to study start was performed. General practitioners (GPs, 12) and gastroenterologists (GIs, 17) reported on treatments given to 91 patients who had experienced at least 1 flare in the past year. Treatment options (increasing dosage of existing treatment, new oral steroid prescription, topical prescription, other prescription, further investigation, and any hospitalisation or surgery) were grouped into 8 distinct treatment patterns. Descriptive statistics and the Fisher exact test were used to assess treatment patterns by type and physician specialty, stratifying by UC status at last assessment (remission vs. mild/moderate).

Results

Top treatment patterns for UC relapse/flare included increasing the dosage of existing medication (19% of patients), prescribing a new oral steroid (19%), and prescribing a combination of 2 treatment options (22%). Any hospitalisation or surgery was reported in 7 cases (8%). Adjusting for mild/moderate UC, GIs more often prescribed 2 or 3 combinations of treatment options compared to GPs (30% and 25% vs. 11.5% and 3.8%), and utilised any hospitalisation/surgery as a treatment option (10% vs. 3.8%); GPs were significantly more likely to report prescribing a new oral steroid only compared to GIs (26.9% vs. 10%; p = 0.03).

Conclusion

While a variety of treatment options were commonly used to treat UC flares, treatment patterns differed by physician specialty, even when adjusting for disease status. Further research is needed to understand how physician treatment patterns may lead to different outcomes in order to improve UC management in the UK.