P0709 - Acceptability and Preferences for Multimodal Inflammatory Bowel Disease (IBD) Self-Help Resources: Patients’ and Providers’ Perspectives

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

Chung Sang Tse, MD

University of Pennsylvania
Philadelphia, PA

Award: Presidential Poster Award

Chung Sang Tse, MD¹, James Lewis, MD, MSCE¹, Samir A. Shah, MD, FACG², Arthur H. Ostrov, MD³, Stephanie Burwell, NP⁴, Jill Gaidos, MD, FACG⁵, Erin Forster, MD, MPH⁶, Hannah Fiske, MD⁷, Melissa G.. Hunt, PhD¹, Robert Kuehnel, PhD⁸, Catherine Soto, MPA⁹, Siddharth Singh, MD¹⁰, Alandra Weaver, MPH⁹, Corey A. Siegel, MD, MS¹¹, Gil Melmed, MD, MS¹², Welmoed van Deen, MD, PhD¹³
¹University of Pennsylvania, Philadelphia, PA; ²Gastroenterology Associates, Inc., Providence, RI; ³Saratoga Schenectady Gastroenterology Associates, Burnt Hills, NY; ⁴Saratoga Schenectady Gastroenterology Associates, Saratoga, NY; ⁵Yale University, New Haven, CT; ⁶Medical University of South Carolina, Charleston, SC; ⁷Brown University, Providence, RI; ⁸Lafayette, NY; ⁹Crohn's and Colitis Foundation, New York, NY; ¹⁰University of California, San Diego, San Diego, CA; ¹¹Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH; ¹²Center for Inflammatory Bowel Diseases, Cedars-Sinai Medical Center, Los Angeles, CA; ¹³Erasmus School of Health Policy & Management, Rotterdam, Zuid-Holland, Netherlands

Introduction: Clinic visits for IBD are often focused on disease management with limited time for a holistic approach, thus self-help resources (tools/programs) for self-management (knowledge/behaviors) are vitally important. We aim to elucidate patients’ and providers’ acceptance of and preferences for 4 publicly available, low-cost IBD self-help resources.

Methods: We surveyed 216 adults with IBD from Feb-May 2023 about their preferences for 4 multimodal IBD self-help interventions: a 1-on-1 peer-to-peer IBD support program, an IBD help center (email/phone/online chat), 2 smartphone apps (access washrooms and track symptoms), and an IBD cognitive behavioral therapy (CBT) workbook. We used logistic regression to identify patient/disease factors associated with patients’ preferences. IBD remission was defined using the 2-item patient-reported outcome measure (PRO-2). Low health confidence was defined as a Wasson’s health confidence score < 8 (range 0-10). We also conducted a focus group with 10 IBD providers to assess acceptability from the providers’ perspectives from the Crohn’s and Colitis Foundation’s IBD Qorus Learning Health System.

Results: Of the 216 adults with IBD (66% female; 83% White, 12% Black, 4% Asian; 56% CD, 44% UC; 54% active, 46% remission), 53% reported low health confidence to manage IBD.

Most patients selected asynchronous, self-directed self-help interventions (79% smartapps; 76% CBT workbook) over synchronous, person-to-person interactions (62% help center; 46% peer-to-peer program). Patients with active IBD, low health confidence, not employed, or high school/sub-Bachelor’s degrees as their highest educational attainment (vs. graduate/professional degrees) were 2-5x more likely to select self-help interventions (Tab 1). IBD subtype, gender, and ethnicity were not associated with patients’ preferences.

IBD providers expressed patient-provider relationships affect their patients' confidence in managing IBD, but that short office visits limit their ability to spend more the time educating patients (Fig 1). IBD providers valued IBD self-help interventions as resources for patients to access information, share experiences, improve self-management, and engage with mental health support.

Discussion: Patients and providers value self-help resources to extend IBD care beyond the traditional patient-provider context. Disease activity and sociodemographic factors are associated with patients' preferences for IBD self-help resources.

Figure: Figure 1: Providers’ Perspectives on Patients’ Health Confidence and IBD Self-Help Resources

Odds Ratio (95% Confidence Interval)	Smartphone App n=178	Peer-To-Peer Support n=203	Information Center n=186	Cognitive Behavioral Therapy Workbook n=183
IBD Disease Activity (Active vs. Remission)	2.9 (1.3-6.4)	2.0 (1.1-3.6)	1.1 (0.6-2.1)	1.3 (0.6-2.7)
Health Confidence (Low vs. High)	3.3 (1.5-7.2)	2.3 (1.3-4.2)	1.9 (1.03-3.5)	1.6 (0.8-3.2)
Education Attainment High School/sub-Bachelor’s degree vs. Graduate/Professional Degree High School/sub-Bachelor’s degree vs. Bachelor’s/Associate Degree Bachelor’s/Associate vs. Graduate/Professional Degree	5.2 (1.2-23.8) 3.8 (0.8-18.0) 1.4 (0.6-2.9)	5.1 (1.9-13.6) 2.8 (1.1-7.7) 1.8 (0.9-3.5)	3.4 (1.2-9.2) 2.0 (0.7-5.6) 1.7 (0.8-3.3)	0.9 (0.3-3.6) 1.3 (0.5-3.4) 1.4 (0.6-3.1)
Employment (Not Employed vs. Employed)	1.8 (0.5-6.5)	3.0 (1.1-8.1)	5.2 (1.5-18.3)	2.4 (0.7-8.5)

Table: Table 1: Patient and Disease Characteristics Associated with Patients’ Preferences for IBD Self-Help Intervention.
Logistic regression was performed to assess patient and disease characteristics associated with patients’ preferences for various IBD self-help interventions. IBD subtype (Crohn’s disease vs ulcerative colitis), gender, and ethnicity were not statistically significant (not presented).
Abbreviations IBD, inflammatory bowel diseases

Disclosures:

Chung Sang Tse indicated no relevant financial relationships.

James Lewis: AbbVie – Consultant, Grant/Research Support. Amgen – Advisor or Review Panel Member. Arena Pharmaceuticals – Advisor or Review Panel Member. Bridge Biotherapeutics – Consultant. Celgene / BMS – Consultant. Dark Canyon Laboratories – Consultant. Dark Canyon Laboratories – Consultant, Stock-privately held company. Entasis Therapeutics – Consultant. Galapagos – Advisory Committee/Board Member. Gilead – Advisor or Review Panel Member. Janssen Pharmaceuticals – Consultant, Grant/Research Support. Merck – Consultant. Multiple manufactures of generic ranitidine – expert witness. Nestle Health Science – Consultant, Grant/Research Support. Pfizer – Advisor or Review Panel Member. Protagonist Therapeutics – Advisory Committee/Board Member. Sanofi – Advisor or Review Panel Member. Scipher Medicine – Consultant. Takeda – Grant/Research Support.

Samir Shah indicated no relevant financial relationships.

Arthur Ostrov indicated no relevant financial relationships.

Stephanie Burwell indicated no relevant financial relationships.

Jill Gaidos: Abbvie – Advisor or Review Panel Member, Grant/Research Support. Bristol Myers Squibb – Grant/Research Support. Pfizer – Consultant, Grant/Research Support.

Erin Forster: Abbvie – Speakers Bureau. BMS – Speakers Bureau. Takeda – Speakers Bureau.

Hannah Fiske indicated no relevant financial relationships.

Melissa Hunt indicated no relevant financial relationships.

Robert Kuehnel indicated no relevant financial relationships.

Catherine Soto indicated no relevant financial relationships.

Siddharth Singh: Pfizer – Advisor or Review Panel Member, Grant/Research Support.

Alandra Weaver indicated no relevant financial relationships.

Corey Siegel: Abbvie – Advisory Committee/Board Member, Consultant, Grant/Research Support, Speakers Bureau. BMS – Advisory Committee/Board Member, Consultant. Eli Lilly – Advisory Committee/Board Member, Consultant. Fresnius – Advisory Committee/Board Member, Consultant. Janssen – Advisory Committee/Board Member, Consultant, Grant/Research Support, Consultant/advisory board, speaker for CME activities. Napo Pharmaceuticals – Advisory Committee/Board Member, Consultant. Pfizer – Advisory Committee/Board Member, Consultant, Grant/Research Support, speaker for CME activities. Prometheus Biosciences – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member, Consultant, Grant/Research Support, Speakers Bureau.

Gil Melmed: AbbVie – Consultant. Amgen – Consultant. Arena – Consultant. BI – Consultant. BMS – Consultant. Dieta – Consultant, Owner/Ownership Interest. Eli Lilly – Employee. Ferring – Consultant. Fresenius Kabi – Consultant. Genetech – Consultant. Gilead – Consultant. Janseen – Consultant. Oshi – Consultant, Owner/Ownership Interest. Pfizer – Consultant, Grant/Research Support. Prometheus Labs – Consultant. Samsung Bioepis – Consultant. Takeda – Consultant. Techlab – Consultant. Viatris – Consultant.

Welmoed van Deen: Ferring Pharmaceuticals – Speakers Bureau.

Chung Sang Tse, MD¹, James Lewis, MD, MSCE¹, Samir A. Shah, MD, FACG², Arthur H. Ostrov, MD³, Stephanie Burwell, NP⁴, Jill Gaidos, MD, FACG⁵, Erin Forster, MD, MPH⁶, Hannah Fiske, MD⁷, Melissa G.. Hunt, PhD¹, Robert Kuehnel, PhD⁸, Catherine Soto, MPA⁹, Siddharth Singh, MD¹⁰, Alandra Weaver, MPH⁹, Corey A. Siegel, MD, MS¹¹, Gil Melmed, MD, MS¹², Welmoed van Deen, MD, PhD¹³. P0709 - Acceptability and Preferences for Multimodal Inflammatory Bowel Disease (IBD) Self-Help Resources: Patients’ and Providers’ Perspectives, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.