P475 Gastroenterological and reumatological chronic patients: are there differences in individual welfare and quality of life?—a cross-observational study
A. Stefani, M. G. Vettorato*, G. Lorenzon, T. Marcon, F. Simonetti, A. Rigo, E. V. Savarino, E. De Marchi, R. D’Incà, G. C. Sturniolo
University of Padua, Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy, Padua, Italy
Inflammatory bowel disease (IBD) and reumatological disease (RD) are chronic, immune-mediated diseases with similarities in pathophysiology and relapsing-remitting course necessitating lifelong treatment, often with the same biological agents, such as anti-TNFs. IBD and RD are both debilitating and disabling, with negative effects on individual welfare and psycho-emotional and social status. Aims: to compare IBD and RD patients in terms of adherence to medical therapy, effect of disease on work, and social activities, as well as on anxiety status.
Demographic data, working activity and disease severity parameters in patients regularly referring to Padua University Hospital for biological treatment for IBD or RD were collected. The Morisky scale (MMS8) was used to measure adherence to therapy other than biologics (range from 1 to 8, where score < 6 = low adherence, 6–7 = moderate adherence, and 8 = high adherence). The Work Productivity and Activity Impairment questionnaire (WPAI) was applied to assess work impairment, whereas the STAI (State-Trait Anxiety Inventory) was used to measure the anxiety status.
In total, 295 consecutive adult patients were enrolled: 194 with IBD (124 Males /70 Females; mean age 44) and 101 with RD (38 M/63 F; mean age 42). No differences were found about age and sex between the 2 groups. Patients with RD presented a longer course of disease (median 14 vs 11 years, p < 0.0001), higher percentage of active disease (50.5% RD vs 23.5% IBD, p < 0.001) and higher rate of unemployed status (45.5% RD vs 30.4% IBD, p < 0.05). STAI underlined higher anxiety in RD patients, both in personality trait (97.3% RD vs 34.0% IBD, p < 0.001) and in emotional state (90.1% RD vs 28.3% IBD, p < 0.001). MMS8 score categories were different between the 2 groups (p = 0.04), with both low- and high-adherence patients mostly in IBD group and medium adherence patients in RD group. Analysing the sub-group of workers, no differences were found in number of patients who lost hours of social activity because disease-related problems, numbers of hours lost, and affection on ability on work/daily activities.
Our study confirmed the important effect of chronic diseases on patients’ welfare, and pointed out that RD patients are more likely to have state/trait anxiety. Moreover, patients with RD are more frequently unemployed probably because of a less responsive disease to drugs. Therefore, RD more frequently affects work ability. Neither IBD nor RD patients showed satisfying levels of adherence to therapy.