logo ecco
Portal

ECCO'24 Abstracts

ECCO'24 Abstracts on the JCC Website

ECCO'24 Abstract Book PDF Version

ECCO'24 Abstracts COI Disclosure

Poster presentations: Clinical: Therapy and Observation 2020

P571 Self-Medication with steroids in ulcerative colitis: Results of a patient survey

F. Mesonero Gismero1, I. Rodriguez-Lago2, M. Cañas3, S. Claudia4, R. Saldaña4, L. Feo-Lucas5, S. Fernandez5, L. Cea-Calvo5, B. Juliá5

1Hospital Ramón y Cajal, Gastroenterology Department- IBD Unit, Madrid, Spain, 2Hospital de Galdakao, Gastroenterology Department- IBD Unit, Galdakao, Spain, 3Hospital Clinico San Carlos, Gastroenterology Department, Madrid, Spain, 4Spanish confederation of associations of patients with Crohn′s disease and Ulcerative colitis ACCU, Accu, Madrid, Spain, 5Merck Sharp and Dohme of Spain, Medical Affairs Department, Madrid, Spain

Background

Medical treatment of mild-to-moderate flares of ulcerative colitis (UC) is based on topical and oral mesalazine, steroids or a combination of both. Sometimes self-medication with any of them can occur during a flare and it could interfere with clinical practice. Our aim was to assess the prevalence of self-medication with steroids in UC-patients and the reasons for this behaviour.

Methods

An anonymous cross-sectional survey was developed by representatives of the Spanish working group on Crohn’s disease and UC (GETECCU), the Spanish nursing working group on Inflammatory bowel disease (IBD) (GETEII) and the Spanish associations of patients with CD and UC (ACCU). A link to the online survey was distributed to adult UC patients through 50 Spanish IBD units as well as in the ACCU webpage. Participants voluntarily answered to the survey based on their own experiences.

Results

A total of 546 patients were included, 61% women, mean age 40 years old. Half of them (51%) were followed-up by IBD specialists, while 47% by general gastroenterologists. Thirty-six (6.6%) patients self-medicated with steroids. The main reasons to self-medicate with steroids were the need for quick relief of symptoms (n = 20, 56%), fear of worsening (n = 17, 47%) and difficulty for getting a medical appointment or being previously prescribed by the doctor (n = 9, 25%, both). Sixty-four per cent of them self-medicate once per year, while 8% self-medicate more than three times per year. Of these patients, 175 (32%) reported that self-medication lasted less than one month, while in 9 (18%) lasted for more than 3 months. Factors related to self-medication with steroids were the increased number of flares (p < 0.001), living with someone who uses oral steroids (p = 0.04), keeping the steroids left after finishing the treatment (p < 0.001), and prescription of corticosteroids in case of worsening by the primary care doctor (p = 0.02). Self-medication was less frequent in those patients who were attended by an IBD specialist (11, 3%), compared of those followed by an internal medicine physician (2, 33%), (p = 0.007), or by a general gastroenterologist (n = 23, 9%), (p = 0.02). Multivariate analysis showed that a higher number of flares [OR 7 (95% CI: 1–32), p < 0.001] and being attended by a general gastroenterologist [OR 0.08 (95% CI=0.01–0.5), p = 0.007] were both associated with a greater frequency of self-medication.

Conclusion

Self-medication with steroids is not a common practice in patients with UC from Spain. However, there is still room for improvement in clinical practice. Characteristics of the healthcare system and the disease may influence the rate of self-medication in UC patients.

This project was endorsed by GETECCU, GETEII, ACCU and funded by MSD Spain.