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P121 Patients’ point of view regarding acceptability and usefulness of inflammatory bowel diseases monitoring tools: results from a nationwide multicentre study (the ACCEPT study)

A. Buisson*1, 2, F. Gonzalez3, F. Poullenot4, S. Nancey5, E. Sollellis1, M. Fumery6, B. Pariente7, M. Flamant8, A. Bourreille9, G. Bonnaud10, S. Mathieu11, A. Thevenin12, M. Duruy13, J. FILIPPI14, F. L’hopital15, F. Luneau16, V. Michalet15, J. Genès15, A. Achim17, E. Cruzille15, G. Bommelaer1, 2, D. Laharie18, L. Peyrin-Biroulet19, B. Pereira20, M. Nachury21, G. Bouguen22

1University Hospital Estaing, Gastroenterology Department, Clermont-Ferrand, France, 2UMR 1071 Inserm/Université d’Auvergne; USC-INRA 2018, Microbes, Intestine, Inflammation and Susceptibility of the Host, Clermont-Ferrand, France, 3Private practice, Nimes, France, 4University Hospital, Gastroenterology Department, Bordeaux, France, 5Hospices Civils de Lyon, Lyon-Sud Hospital, Gastroenterology, Pierre Benite, France, 6University Hospital, Gastroenterology Department, Amiens, France, 7University Hospital, Gastroenterology Department, Lille, France, 8Private practice, Nantes, France, 9University Hospital, Gastroenterology Department, Nantes, France, 10Private practice, Cornebarrieu, France, 11Private practice, Clermont-Ferrand, France, 12Private practice, St Quentin, France, 13Private practice, Arles, France, 14Archet 2 University Hospital, Department of Gastroenterology, Nice, France, 15Private practice, Riom, France, 16Private practice, Chateauroux, France, 17Private practice, Beaumont, France, 18University Hospital, Bordeaux, France, 19CHU Nancy Brabois, Department of Gastroenterology, Vandoeuvre les Nancy, France, 20GM – Clermont-Ferrand University and Medical Centre, Biostatistics Unit , Clermont-Ferrand, France, 21University Hospital of Lille, Gastroenterology, Lille, France, 22University Hospital, Rennes, France

Background

As mucosal healing is the therapeutic goal in inflammatory bowel diseases (IBD), repeated endoscopies are warranted, leading to a real burden for the patients. As such, several non-invasive tools have been developed, but their inconvenience according to the patients remains poorly investigated. In this study, we aimed to evaluate the acceptability and the usefulness of these monitoring tools, from the patients’ perspective.

Methods

IBD patients have been prospectively and consecutively included during 6 weeks in 20 centres (9 university hospital and 11 private practitionners). After validation phase, the questionnaire was composed of a self-administered questionnaire (demographics, acceptability, usefulness visual analogue scales ([VAS] identification of associated factors and patients’ preference), and a physician questionnaire, filled out independently. VAS were expressed as median and compared using usual tests.

Results

Amongst the 916 questionnaires, 477 (randomly selected) have been analysed to date. Considering Crohn’s disease (CD) patients (Figure 1A), the venipuncture (VAS = 9.3) and ultrasound (VAS = 9.4) were the most acceptable tools, whereas rectosigmoidoscopy was the less acceptable (VAS = 4.4). Wireless capsule endoscopy (WCE) (VAS = 8.5) and magnetic resonance enterography (MRE) (VAS = 8.0) were significantly more acceptable than colonoscopy (VAS = 7.0). WCE was also more acceptable than stools collection (VAS = 7.6). Finally, stools collection was significantly more acceptable than colonoscopy. For CD patients, venipuncture (VAS = 9.5) and colonoscopy (VAS = 9.2) were the most useful tools, whereas rectosigmoidoscopy was considered as the less useful (VAS = 6.8). Considering ulcerative colitis (UC) patients, venipuncture was significantly more acceptable (VAS = 9.4) and more useful (VAS = 9.4) than the 3 other usual monitoring tools in UC (Figure 1B). The factors associated with decreased acceptability are given in Table 1.

Table 1 Main factors associated with decreased acceptability of monitoring tools in IBD.

The monitoring tools have been ordered according to patients’ preferences in Figure 1.

Figure 1. Comparison of the acceptability and usefulness scales in CD patients (1A) and UC patients (1B).

Conclusion

The evaluation of acceptability of the different monitoring tools and the identification of the associated factors using a rigorous scientific approach are essential steps to improve the information delivered to the patients, to optimise follow-up adherence of the patients and to develop novel IBD monitoring tools.