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P175. Patients' perceptions, attitudes, and experiences about the management of mild-to-moderate ulcerative colitis

F. Casellas1, D. Ginard2, S. Riestra3, N. Alfaro4, 1Hospital Universitari Vall d'Hebron, Unitat Atenció Crohn-Colitis, Barcelona, Spain, 2Hospital Universitario Son Espases, Gastroenterology Department, Palma de Mallorca, Spain, 3Hospital Universitario Central de Asturias, Gastroenterology Department, Oviedo, Spain, 4Advanced Techniques in Health Services Research (TAISS), Research, Madrid, Spain

Background

The importance of ulcerative colitis (UC) is progressively increasing in the health systems of developed countries. Despite the influence of UC on patients' quality of life, little is known about their satisfaction with clinical management, or with associated drug treatment. Knowing the perception and satisfaction that patients have about the management of their disease, it will allow designing strategies aimed to improve patients' quality of life and promoting adherence and treatment effectiveness. The aim of this study is to understand perceptions, attitudes, experiences, and satisfaction with clinical management of UC patients, particularly in aspects related to treatment.

Methods

A discussion group was performed with eight UC patients in remission who had not received biologics or corticosteroids during the previous year. The heterogeneity was ensured by selecting different UC profiles using the following variables: severity, time since onset, follow-up level of care, currently on treatment, managed by a UC care unit, patients belonging to any patient association and gender. Following qualitative methodology a descriptive-interpretative content analysis was performed to detect emerging categories, building an explanatory framework.

Results

The most frequent mentions are related to diagnostic process, follow-up and treatment. Diagnostic delay was detected due to lack of clinical suspicion from primary care (PC) and delayed diagnostic tests. Patients prefer to receive care on demand, channeled through remote care, which helps to resolve questions about UC, issues with treatment, or when a relapse occurs, and minimizes visits to the hospital. Patients with moderate UC diagnosis perceive some training lacks in PC physicians about management of symptoms, although, in general, they declare their satisfaction with follow-up both in PC and specialist care. When forced to go to the emergency room, they are quite dissatisfied with management, due to the delay in providing symptoms resolution, mainly related to inadequate knowledge of UC management. To avoid this, patients suggest the possibility of receiving care on demand from a specialist in UC. In relation to treatment, patients expect it to be effective, reducing symptoms. Secondly, treatment should be safe, minimizing short and long-term side effects. Regarding to treatment characteristics that patients would like to improve, they mention a reduction in the number of doses and tablets per day, and an increased number of tablets per box.

Conclusion

These results suggest the importance of developing strategies to facilitate care on demand, remote care, and to investigate on effective and safe treatments to improve patients' quality of life.