P361 Adherence to faecal calprotectin test in patients with inflammatory bowel disease
C. Maréchal*1, I. Gastin2, C. Baumann2, B. Dirrenberger1, J.-L. Gueant2, L. Peyrin-Biroulet1
1University hospital, Gastro-enterology, Vandoeuvre-les-Nancy, France, 2Inserm U954, Vandoeuvre-les-Nancy, France
Faecal calprotectin is the most accurate non-invasive marker for monitoring mucosal healing in inflammatory bowel disease (IBD). Some patients may forget or may be reluctant to use this test. We investigated for the first time IBD patients’ adherence to faecal calprotectin test.
We conducted a prospective observational study between December 2013 and February 2015 in a French IBD Centre. A faecal calprotectin was prescribed to all patients seen in our department for their IBD monitoring. They had to return a stool sample for their next infliximab or vedolizumab infusion, and to answer the following questions: did you bring the stool sample to our Department? If not, why? If yes, did you encounter any difficulty?
In total 101 patients were included (men = 50): 77 had Crohn’s disease; 23 ulcerative colitis; and 1 indeterminate colitis. The mean age of included patients was 40 years (range, 19–68). Further, 89 patients were treated with infliximab; 10 with vedolizumab; 1 with thiopurine; and 1 had no IBD-related medications. In addition, 80% of patients (79/101) had clinically quiescent disease at time of survey; 35% of patients (37/101) were bringing the stool sample to our centre; 80% of the patients (81/101) were not aware of faecal calprotectin test; and 77% (78/101) had never performed this test. Reasons for not bringing back the stool sample to our centre were forgetfulness for 76% (49/64), not interested in performing for 9% (6/64), constipation for 8% (5/64), refusal to handle stools for 3% (2/64), and difficulty to collect a stool sample for 1.5% (1/64).
This is the first study addressing the issue of adherence to a faecal marker test in a real-life setting in IBD. Only one-third of the patients brought their stool sample to our centre. The main reason was forgetfulness. The majority of the patients were not aware of faecal calprotectintest. These results show the importance of better therapeutic education to improve patients’ adherence for faecal calprotectin test ad non-invasive monitoring. Several factors could contribute to improved adherence such as a better knowledge of this marker, the development of tools facilitating stool collection, and the development of an easy to use tool for patients to perform the calprotectin stool test at home.