P087 - PATIENT INFLUENCE ON CHOICE OF BIOLOGIC TREATMENTS: A NATIONAL PATIENT CHART AUDIT
(Room Poster Hall)
19 Jan 18
5:30 PM
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7:00 PM
Tracks:
Clinical and Research Challenges
Background: Data are emerging about the role of patient input on decision making for treatment of IBD. There are now multiple options for biologics when considering mechanism of action and means of administration. We sought to understand some of the disconnect between physicians and patients in this arena. Methods: An independent market analytics firm collaborated with US gastroenterologists (n=187) to conduct a retrospective chart review of patients with either ulcerative colitis (UC) (n=475) or Crohn’s disease (CD) (n=566), who had switched from one biologic therapy to another in the prior 12 wks. Gastroenterologists were able to submit up to 7 charts. Data were collected in April 2017 and included clinical and non-clinical patient demographics, as well as patient input into decision making. Results: 40% of patients with UC had “significant input into” the decision to switch biologic agent; in 10% they were the “primary driver” of the switch. Among CD patients the numbers were similar at 45% and 9%, respectively. Primary drivers were significantly younger than those who did not have input (p = .014). This finding was not altered by diagnosis. In biologic switches where the patient was the primary driver, physician’s indicated there was a clinical rationale in 84% of UC and 90% of CD recent biologic switches. In 16% of UC and 10% of CD patient switches physicians indicated there was “no clinical rationale.” Conclusion: Patient influence on the decision to switch biologic treatment has a significant role in choice of biologic. The mean age of patients who were primary drivers of the switch was significantly lower than that of patients less engaged. While most of the switches in primary driver patients had a strong or some clinical rationale, in one in ten cases the physician indicated no clinical rationale.