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P761 Illness cognition of Saudi patients with Crohn’s disease

2020, Journal of Crohn's and Colitis

Background The prevalence of Crohn’s disease (CD) has markedly increased in Saudi Arabia over the past 3 decades.Patients’ awareness of the chronic recurrent course and potential risk of disease complications can lead to a wide range of psychological and interpersonal concerns. Patients’ cognition about the disease and treatment are important mediators as they explain the occurrence of individual differences in the individuals’ adjustment to chronic diseases. The aim of this study is to assess illness cognition of Saudi patients diagnosed with CD and to identify clinical predictors. Methods Consecutive patients with confirmed CD seen in the adult outpatient gastroenterology clinic at King Abdulaziz university hospital were recruited between January and December of 2019. Data was collected from interviews conducted with the patients and from the hospitals’ electronic medical records.The primary endpoint of the study was patients’ illness cognition according to the illness cognition q...

S606 P761 Illness cognition of Saudi patients with Crohn’s disease M.H.A. Mosli*1, A. Saeedi1, M. ALNEFAIE1, N. Bawahab1, L. Abdu1, S. Shobai1 1 Department of Medicine- King Abdulaziz University- Jeddah- Saudi Arabia, Department of Medicine-, Jeddah, Saudi Arabia Background: The prevalence of Crohn’s disease (CD) has markedly increased in Saudi Arabia over the past 3 decades.Patients’ awareness of the chronic recurrent course and potential risk of disease complications can lead to a wide range of psychological and interpersonal concerns. Patients’ cognition about the disease and treatment are important mediators as they explain the occurrence of individual differences in the individuals’ adjustment to chronic diseases. The aim of this study is to assess illness cognition of Saudi patients diagnosed with CD and to identify clinical predictors. Methods: Consecutive patients with confirmed CD seen in the adult outpatient gastroenterology clinic at King Abdulaziz university hospital were recruited between January and December of 2019. Data was collected from interviews conducted with the patients and from the hospitals’ electronic medical records.The primary endpoint of the study was patients’ illness cognition according to the illness cognition questionnaire (ICQ), which can be used to assess three cognitive functions that patients attribute to disease: helplessness (6 items), acceptance (6 items), and perceived benefits (6 items). Each item is scored from 1 to 4, with 1 corresponding to ‘Not’, and 4 corresponding to ‘Totally. Descriptive statistics were used to summarise patient characteristics and linear regression analysis was used to identify predictors of the ICQ score. Results: A total of 88 patients were surveyed, of which 55.8% were females, 18% were smokers and 11.5% had undergone CD-related surgery. The mean age was 26.9 ± 7.7 years and the mean duration of disease was 54.7 ± 60.5 months. Perianal disease was reported by 16.1% of the cohort. Twenty eight percent of patients reported that they ‘completely’ missed things that they like to do the most because of their illness and 35% responded by ‘not at all’ when asked if they had learned to live with their disease. Forty one percent of patients reported that the illness ‘completely’ controls their life and 30% responded by ‘not at all’ when asked if they can accept their illness. Mean ICQ score was 44.3 ( ± 6.6). On linear regression analysis, duration of the disease in months (coef = −0.04, p = 0.008) and fatigue (coef = −1.40, p = 0.04) were predictive of the ICQ score. Conclusion: A considerable proportion of Saudi patients diagnosed with CD report negative perception of their disease. Duration of illness and presence of fatigue appear to be predictive of the ICQ score. P762 Prevalence association between HPV and fistulising perianal Crohn’s disease L. RODRIGUES BOARINI*1, C.W. Sobrado Jr1, V.R. Guzela1, A. Pozzebon Gonçalves1, L. Lina Villa2, S.R. Nadal3, A. Da Costa Lino Costa4, S.C. Nahas1 1 Hospital das Clinicas da Faculdade de Medicina da USP, Inflammatory Bowel Disease Department, São Paulo, Brazil, 2 Hospital das Clinicas da Faculdade de Medicina da USP, HPV Institute, São Paulo, Brazil, 3Instituto de Infectologia Emilio Ribas, Coloproctology department, São Paulo, Brazil, 4Hospital das Clinicas da Faculdade de Medicina da USP, Pathology department, São Paulo, Brazil Background: Perianal Crohn’s disease (PCD) is the main risk factor for squamous cells carcinoma (SCC). The incidence of SCC in PCD patients is 0.26 per 1000 patients-years, affects females more than males, develops on average at 42 years of age, which is earlier than general population. Although epidemiological studies have shown that most anal cancers are associated with HPV infection, predominantly oncogenic types 16 and 18.1 prevalence of HPV on perianal Crohn`s disease (PCD) remains unknown. We aimed to estimate the Prevalence of HPV and the subtypes more frequently associated with PCD. Methods: Adults with fistulising PCD under immunosuppressed medications who have required surgical intervention, were transversally recruited. A biopsy sample was obtained from perianal fistula tract during under anesthesia exam. INNO-LiPA test was performed on paraffin blocks containing fistula path for HPV testing. Results: A total number of 45 PCD patients were recruited and underwent surgical intervention. All patients were under biologic therapy, 42.2% Adalimumab, 40.1% Infliximab, 11.1% Certolizumab, 4.4% Downloaded from https://academic.oup.com/ecco-jcc/article/14/Supplement_1/S606/5706003 by guest on 17 May 2024 is inversely correlated with the degree of inflammation and previous studies have found that mucosal drug concentrations differ between various oral mesalazine preparations. In the current study we have examined the drug persistence of oral mesalazine preparations in a national cohort of UC patients. Methods: Patients with newly diagnosed UC from 2010 to 2014 using oral mesalazine as anti-inflammatory monotherapy 3 months after the time of diagnosis were identified by combining data from the Norwegian Patient Registry and the Norwegian Prescription Database. The patients were retrospectively followed through 2017, median follow-up time was 1029 days. Treatment failure was defined as start of topical mesalazine or glucocorticoid preparations, systemic glucocorticoids, immunomodulators and biologic treatment or a change to another oral mesalazine preparation. Drug persistence was defined as duration of oral mesalazine preparation in monotherapy. Disease was categorised as more severe in patients who had dispensed systemic glucocorticoids the first three months after diagnosis. Drug persistence at national and regional level was stratified by mesalazine preparation (Mezavant (MEZ), Asacol (ASA), Pentasa (PEN), Salofalk (SAL)) and disease severity. Consumption was estimated based on defined daily doses (DDD = 1.5 g) of mesalazine dispensed from pharmacies. Results: A total of 3421 patients were identified. Overall median mesalazine drug persistence was 311 days. The persistence differed between the preparations in descending order: MEZ (398 days), SAL (374 days), PEN (273 days), ASA (266 days), and the order was similar in the four regions. Patients with more severe disease at diagnosis had shorter drug persistence (193 vs. 407 days). Systemic glucocorticoids were given to similar proportion of patients for ASA (0.60) and PEN (0.61), while this proportion of MEZ users was lower (0.52) and even lower for SAL users (0.43). The number of prescribed DDD the first year after diagnosis was slightly higher in MEZ users (MEZ 1.75, ASA 1.36, PEN 1.42, SAL 1.40). Conclusion: There were significant differences in drug persistence between oral preparations that were not explained by differences in prescription at regional level, but could partially be related to differences in disease severity. These differences could have clinical implications and bear further investigations. Poster presentations