Communicating Needs and Features of IBD Experiences (CONFIDE) Survey: Impact of Moderate to Severe Crohn’s Disease Symptoms on Health Care Professional Treatment Decisions in the United States and Europe
AIBD 2023
Background:
The Communicating Needs and Features of IBD Experiences (CONFIDE) study aims to increase the understanding of the experiences and impacts of symptoms on patients’ lives and elucidate any gaps in communication between health care professionals (HCPs) and patients with moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD) in the United States (US), Europe (France, Germany, Italy, Spain, and UK), and Japan. A previous analysis from the CONFIDE study identified a communication gap between HCPs and patients with moderate to severe UC and highlighted the under-appreciation of bowel urgency as part of treatment decisions by HCPs. This study assessed the impact of moderate to severe CD symptoms on HCPs’ treatment decisions.
Methods:
Data collected from online, quantitative, cross-sectional surveys conducted among US and European HCPs and patients with moderate to severe CD were analyzed in this study. Moderate-to-severe CD was defined using criteria based on previous treatment, steroid use, and/or hospitalization. HCPs included physicians (US: 89.0%; Europe: 93.8%) and non-physician HCPs (US: 11.0%; Europe: 6.2%) who were responsible for making treatment decisions for CD. Descriptive statistics were used to present the data.
Results:
A total of 762 patients with moderate to severe CD (US: 215 and Europe: 547) and 703 HCPs (US: 200 and Europe: 503) completed the surveys. The mean age of patients was 40.9 years in the US and 38.0 years in Europe, and the majority of patients were male (US: 54.9%; Europe: 55.4%). Most common current symptoms reported by patients were diarrhea (US: 55.3%; Europe: 54.7%), bowel urgency (US: 42.3%; Europe: 38.0%), and increased stool frequency (US: 40.0% and Europe: 36.6%). Patients reported diarrhea (US: 68.9%; Europe: 74.9%), bowel urgency (US: 61.9%; Europe: 70.8%), and increased stool frequency (US and Europe: 54.7% each) as the top three symptoms that had the greatest impact on them. A total of 19.0% US and 15.5% European HCPs perceived bowel urgency among the top five symptoms most reported by patients. The HCP-rated top three symptoms with greatest impact on patients were diarrhea (US: 71.5%; Europe: 73.2%), blood in stool (US: 48.0%; Europe: 33.8%), and increased stool frequency (US: 39.0%; Europe: 37.2%). The top three symptoms with the greatest impact on HCPs’ treatment decisions were diarrhea (US: 60.0%; Europe: 63.6%), blood in stool (US: 51.5%; Europe: 34.6%), and increased stool frequency (US: 28.0%; Europe: 25.2%).
Conclusions:
Both US and European patients classified bowel urgency among the top three most reported symptoms. It was the second most frequently reported symptom with greatest impact among patients with moderate to severe CD. However, bowel urgency was neither among the HCP-perceived top three most reported symptoms by patients nor among the HCP-ranked top three symptoms with greatest impact on patients. It was also not influencing their treatment decisions. Similar to the findings of a previous analysis from the CONFIDE study in patients with UC, the results highlight a communication gap between patients with CD and HCPs and the under-appreciation of bowel urgency among HCPs. Despite the high prevalence of bowel urgency and its importance among patients with moderate to severe CD, most HCPs do not consider this symptom in their treatment decisions.
