P636 Patient support programme is well accepted and could help adherence in inflammatory bowel disease patients
G. Lorenzon*1, M. G. Vettorato1, E. De Marchi1, O. Bartolo1, R. Caccaro1, F. Cavallin2, G. Girardin1, A. Rigo1, F. Simonetti1, E. V. Savarino1, G. C. Sturniolo1, R. D’Incà1
1University of Padua, Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy, Padua, Italy, 2University of Padua, Surgical Oncology Unit, Regional Centre for Oesophageal Disease, Veneto Institute of Oncology, Padua, Italy, Padua, Italy
In inflammatory bowel disease (IBD) patients (pts), adherence to therapy and to outpatient visits is sub-optimal. A patient support programme (PSP) provided by trained individuals(not health care providers) was offered to patients in biological therapy to improve knowledge about the disease by providing information on how to take prescribed medication correctly, answers to patients’ questions about the disease and its treatments, and a contact point. The aim of the study was to measure the acceptance of and satisfaction with the program and its efficacy in improving adherence to treatment and follow-up, disease outcome, quality of life, and work productivity in IBD pts.
In total, 162 IBD pts on biological therapy were enrolled. PSP was randomly offered to 81 patients, whereas the other 81 patients followed the conventional management (CM). We collected data about disease activity using the h Harvey–Bradshaw Index (HBI) and Modified Truelove and Witts Severity Index (MTWSI); adherence to therapy (Morisky scale MMS8, range from 1 to 8, where score < 8 = low adherence, 6–7 = moderate adherence, and 8 = high adherence); work productivity and daily activities, according to the Work Productivity Ability Index (WPAI); and quality of life (Short Inflammatory Bowel Disease Questionnaire S-IBDQ). Data were collected at inclusion and after 6 months. At the end of follow-up, the pts satisfaction was measured through a questionnaire and a visual analogic scale (VAS).
In total, 53 out of 81(65%) pts accepted (A-PSP), and 28 (35%) refused (R-PSP) the PSP. Further, 74 out (91.3%) of 81 pts assigned to receive CM were included because 7 did not attend the follow-up visit. The A-PSP, R-PSP, and CM groups were comparable in terms of demographic data, disease activity, and disease duration at baseline. High grade of education was seen in 82% of R-PSP pts, and in 58% of A-PSP pts (p = 0.05). MMS8 score improved by 27.3% in the CM group; 39.5% in the A-PSP; and 25% in the R-PSP group during follow-up. High adherence was observed in 84% of the A-PSP; 42% of the CM; and 100% of the R-PSP group during follow-up (p = 0.03). Acceptance of the PSP decreased in pts with higher degree of education, although not statistically significantly (82.1% vs 58.5%p = 0.10). Satisfaction with the program was perceived as high in 78% of the participants with a median VAS of 7 (IQR 5–9). Quality of life and limitation in daily activities, significantly improved in the A-PSP group (p = 0.007), but not in the R-PSP (p = 0.26) and CM groups (p = 0.12) at 6 months of follow-up. No improvement in WPAI was observed in any of the groups.
Overall, PSP was well accepted by the participants, with the highest acceptance in pts with low grade of education. PSP could improve adherence over time and quality of life in IBD pts, especially in those with poor adherence to therapy, by increasing patients’ confidence/education and perception of support and care.