P0444Medication adherence, hospitalization burden, and disease duration as determinants of quality of life in IBD

Abstract Background Health-related quality of life (HRQoL) is a core outcome in IBD, but evidence from Latin America remains scarce, and the impact of modifiable factors such as treatment adherence and hospitalization burden is uncertain. We aimed to identify clinical determinants of SIBDQ scores in ulcerative colitis and Crohn’s disease in a Brazilian tertiary center. Methods Observational, cross-sectional study of consecutive patients with ulcerative colitis (UC) or Crohn’s disease (CD). Primary outcome: SIBDQ total score (10–70; higher = better). Group comparisons used Mann–Whitney and Kruskal–Wallis tests; medians IQR are reported. We fitted quantile regression models at the median (τ = 0.5) for IBD overall and separately for UC and CD. Candidate predictors included sex, age (30 vs ≤ 30 years), medication use (regular vs irregular), ≥ 2 hospitalizations for disease activity (vs 0–1), clinical activity (active vs remission), time since diagnosis (1, 1–5, ≥5 years), and comorbidities. Backward elimination used p 0.20; collinearity was checked (VIF5). Results We analyzed 214 patients (UC = 118; CD = 96); 62% were women and 73% lived in urban areas. Most patients belonged to the lower socioeconomic strata (UC = 84%; CD = 79%). Biologic use occurred in 39% overall (UC 25%, CD 57%). SIBDQ ≥ 50 was observed in 63% overall (UC 64%, CD 61%). Adjusted effects (β, change in median SIBDQ): higher QoL was associated with male sex (β = +6.82; 95% CI 2.10–11.54; p = 0.005) and disease duration ≥5 years (β = +11.10; 95% CI 2.95–19.25; p = 0.008). By contrast, irregular medication use (β = −9.00; p = 0.016) and ≥ 2 hospitalizations (β = −11.00; p 0.001) were linked to lower QoL; active disease showed a non-significant decrease (β = −4.28; p = 0.087). Crohn’s disease (CD): Higher QoL (higher median SIBDQ) was associated with male sex (β = +9.00; 95% CI 2.59–15.41; p = 0.006) and disease duration 1–5 years (β = +13.00; 95% CI 1.45–24.55; p = 0.028) and ≥5 years (β = +13.00; 95% CI 1.97–24.03; p = 0.021). Lower QoL was associated with active disease (β = −16.00; 95% CI − 23.24 to − 8.76; p 0.001); and irregular medication use showed a borderline decrease (β = −8.00; p = 0.060). Ulcerative colitis (UC): Higher QoL was associated with male sex (β = +6.68; 95% CI 2.01–11.34; p = 0.005). Lower QoL was associated with ≥ 2 hospitalizations (β = −12.00; 95% CI − 19.54 to − 4.46; p = 0.002). Other covariates were not significant. Conclusion In this IBD cohort, poorer QoL clustered with modifiable factors (irregular therapy use and frequent hospitalizations) and with active Crohn’s disease. Longer disease duration and male sex were associated with higher median SIBDQ scores. Interventions to improve adherence and reduce flare-related admissions may yield clinically meaningful QoL gains, particularly in Crohn’s disease. References: 1. Irvine EJ, Zhou Q, Thompson AK. The short inflammatory bowel disease questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. Am J Gastroenterol. 1996;91(8):1571-1578. 2. Calderón M, Minckas N, Nuñez S, Ciapponi A. Inflammatory bowel disease in Latin America: a systematic review. Value Health Reg Issues. 2018;17:126-134. 3. Jäghult S, Saboonchi F, Johansson U-B, Wredling R, Kapraali M. Identifying predictors of low health-related quality of life among patients with inflammatory bowel disease: comparison between Crohn’s disease and ulcerative colitis with disease duration. J Clin Nurs. 2011;20(11-12):1578-1587. doi:10.1111/j.1365-2702.2010.03614.x Conflict of interest: Rolim, Mariana: In the past 36 months, I have received support for congress attendance from AbbVie, Johnson &amp Johnson Innovative Medicine (Janssen), and Takeda. I have received speaker honoraria from Johnson &amp Johnson Innovative Medicine (Janssen) and Takeda. Silva Almeida, Diego: No conflict of interest Rolim, Ticiana: No conflict of interest Neves Jacinto, Camilla: No conflict of interest Benevides Leite, Andrea: No conflict of interest Maia Evangelista, Marina: No conflict of interest Duarte de Figueredo, Maria Clara: No conflict of interest Lima de Almeida, Paola: No conflict of interest Gadelha Rattacaso, Gabriela: No conflict of interest