P509. Evaluating clinical practice patterns with inflammatory bowel disease health care assessment questionnaires (POLARIS): a patient- and a physician-reported survey
S. Ghosh1, S. Schreiber2, J. Petkau1, B. Bressler3, R.B. Thakkar4, M. Yang4, M. Skup4, J. Chao4, P.M. Mulani4, R. Panaccione1, 1University of Calgary, Calgary, Alberta, Canada, 2Christian-Albrechts University, Kiel, Germany, 3University of British Columbia, Vancouver, Canada, 4Abbott Laboratories, Abbott Park, IL, United States
POLARIS, a cross-sectional study employing paper-based questionnaires, assessed treatment patterns and quality of care from the perspective of patients with Crohn's disease (CD) and their health care providers (HCPs).
Surveys were administered at inflammatory bowel disease (IBD) centres and community practices in Canada and Germany. Patients ≥18 years old with a confirmed diagnosis of CD, disease duration ≥1 year, and ≥2 visits with a participating HCP were eligible. HCPs assessed clinical remission rates, defined as Harvey Bradshaw Index (HBI) Score <5. CD-related hospitalization and/or surgery rates in the previous 12 months were assessed. Baseline and concomitant therapy use was obtained from patients and HCPs. General quality of life (using EuroQol 5D [EQ-5D]) and work days lost or days unable to participate in normal activities in the previous month were also assessed in the patient survey.
A total of 810 patients were enrolled; questionnaires from 640 patients (269 in Canada and 371 in Germany) were available for this preliminary analysis. The study population age was 41.4 years old, 44.6% were men, and CD duration averaged 13.5 years. IBD centres were the source of patient recruitment for 88.4% of patients in Canada and 40.4% in Germany. The overall HBI remission rate was 76.3% (76.2% in Canada and 76.3% in Germany); 14.7% of patients had ≥1 CD-related hospitalization in the past year, and 5.9% had a CD-related surgery. In IBD centres, 40.2% of patients were referred by a specialist (within the same hospital/clinic or from another hospital) or a surgeon. Overall, 44.9% of patients visited their HCPs every 3 months. Medication use in the past year, based on HCP assessment, included immunosuppressants (IMMs) in 49.1% and biologic therapy in 45.2%, with greater use of IMMs (56.7% vs. 37.4%, P < 0.001) and biologics (50.3% vs. 37.4%, P = 0.001) in IBD centres compared with non-IBD centres. 14.2% of patients used steroid for ≥3 months in past 12 months. Average EQ-5D utility score (range: 0 = worst health scenario to 1.0 = best health scenario) was 0.8, and patient-reported time unable to work or to go about normal activities because of CD in the last month averaged 4.3 days.
The high remission rate observed in this patient- and HCP-based survey in Canada and Germany indicates that CD was generally well controlled in this population. Use of biologics and IMMs was relatively high, particularly in IBD centres in which ≥50% of patients were receiving these agents.