P0797The Influence of Psychological support in Patients with Ulcerative Colitis to Achieve steroid-free Remission

Abstract Background Approximately 20% of patients with ulcerative colitis have a chronic active disease (chronic continuous course), which often requires several courses of systemic glucocorticosteroids (GCS) to achieve remission, but which is followed by a recurrence of symptoms during a reduction in the dose of steroids or shortly after their withdrawal. Although short-term symptom control can be achieved with steroid treatment, this pattern of drug reaction, known as steroid dependence, leads to important treatment complications, while a significant proportion of patients require colectomy. Accordingly, the need for the appointment of GCS is considered as one of the main criteria for the effectiveness of the therapy of ulcerative colitis (UC). Aim. To evaluate the increase in adherence to drug therapy through psychological support to achieve steroid-free remission. Methods Medical support for patients with UC in the Department of IBD was provided by a medical psychologist. Of the 1000 patients with UC who underwent a questionnaire to assess adherence to drug therapy, 874 (87.4%) patients were re-interviewed and clinical laboratory and instrumental studies were performed after 6 months after discharge from the hospital. Results Among the 874 patients who underwent repeated questioning, 498 (56.9%) had low adherence to drug therapy. 180 (20.6%) patients with UC with low adherence to drug therapy had psychological support, 318 (79.4%) patients from the low-adherence group did not have psychological support. In our study, there were differences in the need for GCS prescribing in groups of patients with and without psychological support. Of the 180 patients in the group with psychological support, 16 (8.9%) patients had a need for GCS, and 97 (30.5%) patients in the group without psychological support (OR 4.499; 95% CI 2.554- 7.925; x2 - 29.391; p 0.001). Conclusion Increased adherence to drug therapy through psychological support increases the likelihood of developing steroid-free remission in patients with UC. Conflict of interest: Prof. Knyazev, Oleg: No conflict of interest Firsova, Lyudmila: No conflict of interest Gorodetskaya, Anait: No conflict of interest Kagramanova, Anna Valeryevna: No conflict of interest