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P677 Use and predictors of complementary and alternative medicine in patients with inflammatory bowel disease: results of a multicentre study of the Austrian IBD Study Group (ATISG)

H. P. Gröchenig*1, C. Dejaco2, G. Eckhard3, T. Feichtenschlager4, T. Haas5, A. Kirchgatterer6, R. Koch7, O. Ludwiczek8, A. Mayer9, W. Miehsler10, P. Papay11, P.-G. Peters12, R. Platzer13, G. Reicht14, P. Steiner15, T. Waldhör16, H. Wenzl17, H. Fuchssteiner18, J. Gartner19, G. Novacek2

1Krankenhaus Barmherzige Brüder, Innere Medizin, St Veit an der Glan, Austria, 2Medizinische Universität Wien, Universitätsklinik für Innere Medizin III, Vienna, Austria, 3Landeskrankenhaus Oberpullendorf, Interne Abteilung, Oberpullendorf, Austria, 4Krankenhaus Rudolfstiftung Wien, IV Medizinische Abteilung, Wien, Austria, 5Darmpraxis Salzburg, Ordination, Salzburg, Austria, 6Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin V, Grieskirchen, Austria, 7Medizinische Universität Innsbruck, Innere Medizin I, Innsbruck, Austria, 8Landeskrankenhaus Hall in Tirol, Innere Medizin, Hall in Tirol, Austria, 9Universitätsklinikum St. Pölten, 2. Medizinische Abteilung, St. Pölten, Austria, 10Krankenhaus Barmherzige Brüder, Innere Medizin, Salzburg, Austria, 11Hartmannspital Wien, Innere Medizin, Wien, Austria, 12Landeskrankenhaus Feldkirch, Abteilung für Innere Medizin, Feldkirch, Austria, 13Landeskrankenhaus Wiener Neustadt, Abteilung für Innere Medizin I, Wiener Neustadt, Austria, 14Krankenhaus Barmherzige Brüder Graz, Abteilung für Innere Medizin, Graz, Austria, 15Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin I, Wels, Austria, 16Medizinische Universität Wien, Abteilung für Epidemiologie, Wien, Austria, 17Medizinische Universität Graz, Abteilung für Gastroenterologie & Hepatologie, Graz, Austria, 18KH Elisabethinen Linz, Innere Medizin IV, Linz, Austria, 19Hanusch Krankenhaus, Innere Medizin, Wien, Austria

Background

CAM use, especially in chronic diseases such as inflammatory bowel diseases (IBD), is common in Western European countries. The reported frequency is ranging between 20% and 50%. No recent data on CAM use are available for Austrian IBD patients. The aim of our study was to determine the frequency and predictors of CAM use in IBD patients in Austria.

Methods

In a cross-sectional study design, adult patients with IBD (Crohn’s disease [CD], ulcerative colitis [UC], and inflammatory bowel disease unclassified [IBDU]) attending outpatient clinics at 18 hospitals throughout Austria were recruited to complete a multi-item questionnaire. Between June 2014 and June 2015, 1 338 patients were included. Surveyed data consist of demography, clinical variables, and the use of CAM for IBD. Disease activity was determined by patient estimation. The survey preparation, data capturing, and exploratory data analysis were performed by using EvaSys software and SPSS. The presented data focus on CAM use since diagnosis of IBD.

Results

During the 12-month study period, 1 338 patients (64.5% with CD, 33.8% with UC, and 1.6% with IBDU) with a mean age at investigation of 43.4 years (range 18–87 years) were included. The prevalence of CAM use was 50.7% without significant difference between CD and UC. Females used CAM more often than males do (59.7 % vs 41.9%, p < 0.001). Other predictors for CAM use were a non-smoking status (non-smokers 53% vs active smokers 46.1%), higher income (> 50.000 €/y 65.5% vs < 20.000 €/y 43.7%), and medical non-compliance measured by Morisky 4-item medication adherence scale (low adherence 53.5% vs high adherence 48.8%). Overall disease activity was not positive associated with CAM use (inactive disease 50.2% vs active disease 51.1%). The most common reasons cited for using CAM were the wish to take personal responsibility to treatment (60.2%) and an integrated disease approach (55.5%). In the patient population without CAM, use the main reasons for non-use were satisfaction with conventional medicine (72.9%), no personal need for further therapy (65.5%), and missing information about CAM therapy (59.6%).

Conclusion

CAM use for IBD is frequent in Austrian IBD patients, and it is associated with female gender, higher income, non-smoking status, and low adherence to conventional therapy. The main pull factors to CAM therapies are the wish for personal treatment responsibility and an integrated disease approach.