P602 Changes in emotional health and work-related outcomes in patients with moderate to severe ulcerative colitis 1 year after diagnosis: Results from the MOSAIK cohort in Korea
Y. PARK1, J.H. Cheon1, Y.S. Park2, K.C. Huh3, J.E. Shin4, J.M. Cha5, Y.S. Kim6, C.S. Eun7, S.M. Yoon8, Y.S. Park9, B.D. Ye10, B. Seo11, Y. Kim11, MOSAIK
1Departments of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea Republic of, 2Department of Internal Medicine, Eulji University School of Medicine, Eulji Hospital, Seoul, Korea Republic of, 3Division of Gastroenterology, Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea, Republic of, 4Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea Republic of, 5Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea Republic of, 6Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea- Republic of, 7Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea Republic of, 8Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea Republic of, 9College of Medicine, Seoul National University Bundang Hospital, Department of Internal Medicine, Seongnam-si, Korea Republic of, 10Asan Medical Center, University of Ulsan College of Medicine, Department of Gastroenterology and Inflammatory Bowel Disease Center, Seoul National University, Seoul, Korea Republic of, 11Clinical Research Team, Medical Affairs, Janssen Korea Ltd., Seoul, Korea Republic of
Background
As the treatment paradigm of inflammatory bowel disease changes towards patient-centred treatment, it is becoming increasingly important to measure patient-reported outcomes (PROs). We aimed to identify the changes of emotional health and work- or activity-related outcomes one year after the diagnosis of ulcerative colitis (UC) and its predictors in patients enrolled in the moderate-to-severe UC in Korea (MOSAIK) cohort (ClinicalTrials.gov: NCT02229344).
Methods
The MOSAIK cohort is the first nationwide, prospective, inception cohort on moderate-to-severe UC in Korea. Between August 2014 and March 2017, consecutive patients from 30 tertiary hospitals were enrolled. PRO data including hospital anxiety and depression scale (HADS) for emotional health, and work productivity and activity impairment (WPAI) questionnaire for work- or activity-related outcomes, were collected within the first 4 weeks of diagnosis via patient surveys. Wilcoxon-signed rank tests and linear mixed-effects regression models were used for paired comparisons between baseline and 1 year and assessing the predictors of HADS and WPAI.
Results
Of the 368 enrolled patients, 333 eligible patients were analyzed. The mean age at diagnosis was 39 years and 57.7% (192/333) were male. A considerable number of patients had moderate to high (≥11 by HADS) levels of anxiety and depression (16.0% and 20.5%, respectively), and about half of patients had work and activity impairment (45.5% and 45.8%%, respectively) at baseline. After 1 year follow-up, significant reduction of anxiety and depression (mean difference [MD] in HADS score -1.3 for both anxiety and depression,
| N | Baseline | 1 Year | ||
| HADS, mean (SD) | ||||
| Anxiety | 185 | 6.3 (4.6) | 5.0 (4.2) | <0.001 |
| Depression | 186 | 6.7 (4.3) | 5.4 (3.9) | <0.001 |
| WPAI: UC, mean (SD) | ||||
| Absenteeism | 62 | 28.6 (35.0) | 5.2 (15.5) | <0.001 |
| Presenteeism | 65 | 36.2 (31.5) | 16.8 (19.9) | <0.001 |
| Overall work impairment | 54 | 44.3 (31.8) | 20.2 (21.0) | <0.001 |
| Social activity impairment | 181 | 45.1 (30.6) | 22.7 (24.3) | <0.001 |
Conclusion
Newly diagnosed moderate-to-severe UC patients had considerable anxiety, depression, and work and activity impairment at baseline, but significant improvement was noted after 1 year. Controlling symptoms and disease activity was the most important factor to improve PROs after 1 year.