P052  Impact of COVID-19 pandemic in treatment adherence in Inflammatory Bowel Disease patients

P052  Impact of COVID-19 pandemic in treatment adherence in Inflammatory Bowel Disease patients

Quera Rodrigo1, Simian Daniela1, Flores Lilian1, Ibáñez Patricio1, Lubascher Jaime1, Figueroa Carolina1, Pizarro Gonzalo1, Kronberg Udo1
1 Clínica Las Condes, Santiago, Chile

BACKGROUND: Treatment adherence is a frequent problem in patients with Inflammatory Bowel Disease (IBD). It is known that non-adherence has a negative impact on disease outcomes. The fear of immunosuppressive effects of IBD treatments may influence treatment adherence behavior during COVID-19 outbreak, although information is scarce. The aim of this study was to describe treatment adherence in IBD patients during COVID-19 pandemic.

METHODS: A descriptive, cross-sectional study was performed between August 24th and September 10th, 2020 in patients in follow-up in the IBD Program of Clínica las Condes tertiary referral center. An online survey was sent through REDCap®, including adherence to IBD medication, treatment suspension or modification causes and fear of coronavirus infection. Statistical analysis was performed using frequency, medians, and Mann Whitney test (p<0,05).

RESULTS: A total of 458 patients responded to the survey (32% of IBD patients in follow-up); 66% women, 65% ulcerative colitis, median age 38 (range 18 – 90). Most of the patients were working, 46% teleworking and 17% in person. The treatment at the beginning of the pandemic was 5-ASA (46%), azathioprine/methotrexate (16%), biological therapy (25%), and no treatment (10%). Nine percent of the patients suspended treatment, with the majority of those self-discontinuing (70%) and 22% modified the treatment (62% due to medical indication). In the univariate analysis, patients receiving immunomodulator/biological therapy discontinued treatment less frequently (p = 0.018). Other variables such as age, gender, comorbidities, type of IBD and working status were not related to treatment adherence. Seventy percent of patients reported fear of developing COVID-19 due to IBD. Female patients reported significantly more fear [female 73 (IQR 50 – 90) vs male 57 (IQR 30 – 78,7); p=0.0008]. Although patients with additional comorbidities reported significantly more fear of developing COVID-19 [comorbidity 72,5 (IQR 50 – 90) vs without comorbidity 69 (IQR 40,5 – 80)], this did not impact discontinuation of therapy. The adherence to immunomodulator/biological therapies were not associated with fear of developing COVID-19.

CONCLUSION(S): In this study, adherence to IBD treatment was higher than what has previously been published but may be impacted by fear of infection with COVID-19.  Education strategies implemented by the IBD multidisciplinary team may improve medication adherence.