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P307. Treatment preferences of patients with Crohn's disease candidates for anti-TNF treatment. A conjoint analysis (IMPLICA study)

N. Borruel1, C. Taxonera2, J. Castro3, L. Rodríguez-San Pedro4, M. Costi5, S. Riestra6, F. Casellas1, 1Hospital Vall d'Hebron, Crohn's and Colitis Attention Unit. Digestive System Research Unit, Barcelona, Spain, 2Hospital Clinico San Carlos, Department Gastroenterology, Madrid, Spain, 3Hospital Arquitecto Marcide Ferroll, Gastroenterology, Ferroll, Spain, 4AbbVie Deutschland GmbH & Co, KG, GPRD, Ludwigshafen, Germany, 5Abbvie, Medical Department, Madrid, Spain, 6Hospital Central de Asturias, Department Gastroenterology, Oviedo, Spain

Background

Identify which attributes relating to the biological treatment (BT) of moderate to severe Crohn's disease (CD) are most highly evaluated by patients.

Methods

Observational, cross-sectional, multicentre study. Patients included were diagnosed with moderate–severe CD and were potential candidates for receiving any BT for CD. The patient answered IMPLICA-questionnaire to evaluate the preferences regarding treatment attributes. This questionnaire were selected and validated by means of a comprehension test completed by 20 patients. Conjoint analysis was used to measure the treatment preferences of patients. Questionnaire had 7 possible scenarios (A to F) with a combination of 3 attributes related to different characteristics of BT (see table).

The scenarios were scored from 0 (I never choose it) to 4 (I always choose it). IMPLICA-questionnaire was provided prior to the visit with the investigator, who was aware of the patient's preferred treatment option but prescription was based on routine clinical practice. The study was sponsored by Abbvie.

Results

201 patients recruited by 19 Spanish gastroenterologists were included. 55.7% were male and mean (SD) age was 38.9 (12.3) years. The mean (SD) disease duration was 8.6 (8.1) years. Most of the patients had disease in the terminal ileum (L1: 42.3%), with a non-structuring, non-penetrating behaviour (B1: 54.7%). Perianal disease was present in 41 (20.4%) patients. 102 patients (50.7%) were in clinical remission. Scenarios E and F were the most preferred (57.3% and 53.7% respectively). The least preferred was scenario A (19.9%). Treatment administered by healthcare personnel (0.155), treatment administered at home (0.485) and subcutaneous treatments (0.053) were considered as the most useful. These scores indicate the value of each characteristic has been perceived by patients [from 1 (high) to 0 (low)]. And the result of the most influence factor when choosing a CD therapy is the place where the treatment is administered with an importance of 50.7%.

Route of administrationPerson administering treatmentPlace of administration
AIntravenousHealthcare staffHospital
BIntravenousHealthcare staffOutpatients
CSubcutaneousHealthcare staffHospital
DSubcutaneousHealthcare staffOutpatients
ESubcutaneousHealthcare staffAt home
FSubcutaneousSelf-administrationAt home
GSubcutaneousFamily member or carerAt home

Conclusion

A validated questionnaire to evaluate patient's preferences has been applied to CD patients, enabling involvement of the patient in treatment making decisions, which could have the benefit of improving adherence and effectiveness. The results demonstrated that treatment administered at home had the greatest impact on preferences.