P562 Web-based questionnaire survey about self-management for patients with Inflammatory Bowel Disease in Japan
Nagahori, M.(1);Imai, T.(2);Tairaka, A.(2);
(1)Tokyo Medical and Dental University, Department of Gastroenterology and Hepatology, Tokyo, Japan;(2)Takeda Pharmaceutical Company Limited, Japan Medical Office, Tokyo, Japan
The importance of self-management (SMN) has been widely recognized in chronic diseases but the concept remains complex and its evaluation diverse. There is a limited number of studies evaluating SMN in Inflammatory Bowel Diseases (IBD), and notably in Japan. We have therefore explored the actual utilization of SMN in IBD, the type of supports needed by the IBD patients, and the phenotypic differences between patients with and without SMN.
We conducted a web-based survey considering SMN components as diet, treatment, symptoms/physical conditions, stress, financial worries, and support services from February to March 2020. Subjects were recruited from the Japanese IBD patients’ panel and solicited by email for participation. SMN patients were defined as those responding positively to 3 questions about (1) habit of checking nutrition labelling (2) adjustment of their diet (3) modification of their daily life behavior according to the health conditions. Factors associated with the SMN utilization were also analysed by logistic regression analysis.
Among 371 evaluable patients［Ulcerative Colitis (UC): n=210, Crohn's Disease (CD): n=161, mean age=42 years, mean disease duration=10.2 years］, 59.6% composed the SMN group (UC: 54.3% CD: 66.5%). 87.9% responded “able to live well with IBD” (UC: 90.5% CD: 84.5%, SMN: 92.3% vs non-SMN: 81.3% p=0.002), and 74.4% responded “checking nutrition labelling when buying food” (UC: 67.1% CD: 83.9%) but only 18.3% kept a regular record of diet (UC: 16.7% CD: 20.5%, SMN: 24.9% non-SMN: 8.7%) and 26.1% for symptoms record (UC: 29.5% CD:21.7%, SMN: 29.9% non-SMN: 20.7%). Doctors and families were the most consulted partners for lifestyle, symptoms and treatment by all patients, while CD patients, compared to UC ones, privileged nurses and other IBD patients. As between patients treated or not with biologics and janus kinase inhibitor (Bio/JAKi), there were more items demonstrating significant differences such as the utilization of SMN in UC than in CD. Patients with Bio/JAKi significantly responded more often to be “satisfied with their current treatment”. Meanwhile, patients with hospitalization or surgery histories as well as UC patients with Bio/JAKi showed higher proportions of SMN utilization. “Having 3 or more kinds of people to consult about lifestyle” in UC and “History of hospitalization” in CD were the most influential factors of SMN utilization. Financial/Employment aspects (77.4%) was the most desired support for all patients.
This is the first survey to reveal the actual utilization of SMN and its possible benefits in IBD patients in Japan. Our results suggested that SMN contributes to a better living with IBD for Japanese IBD patients.