Jessica L. Sheehan, MD, MSc1, Molly Stone, MD1, Laura Johnson, BS1, Shirley Cohen-Mekelburg, MD, MS2, Peter Higgins, MD1 1University of Michigan, Ann Arbor, MI; 2Michigan Medicine, Ann Arbor, MI
Introduction: Pain and fatigue are commonly reported in patients with inflammatory bowel disease (IBD) and are associated with increased healthcare utilization. However, few evidence-based treatments for these symptoms exist. Social vulnerability is one psychosocial factor which has been associated with increased healthcare utilization among patients with IBD, but little is known about the relationship between social vulnerability and the patient experience of pain and fatigue. We aimed understand the association between social vulnerability and symptoms of pain and fatigue in IBD.
Methods: We identified a longitudinal cohort of patients who received IBD care within a single tertiary referral center between 2015-2022 and completed at least one Crohn’s disease or ulcerative colitis patient-reported outcomes (CD-/UC-PRO) measure as part of routine clinic care. Using their home address, we geocoded patients to their census tract and corresponding Center for Disease Control’s Social Vulnerability Index (SVI). We separately examined the association between SVI and symptoms of moderate-to-severe abdominal pain, joint pain, and fatigue using multivariable logistic regression and adjusting a priori for IBD type, age, gender, race/ethnicity, language, IBD medications, IBD severity, and comorbid anxiety or depression.
Results: We identified 3,713 patients with IBD who completed at least one CD-/UC-PRO. The majority (56%) of patients had Crohn’s disease, 55% were female, 88% were white, and 78% had moderate-to-severe IBD. Moderate-to-severe abdominal pain, joint pain, and fatigue were reported in 27%, 29%, and 54% of patients, respectively. Higher social vulnerability was associated with a greater likelihood of moderate-to-severe abdominal pain (OR 3.02, p < 0.001), joint pain (OR 2.64, p < 0.001), and fatigue (OR 2.12, p < 0.001) on multivariable logistic regression. Crohn’s disease, female gender, depression, and anxiety were also each associated with pain and fatigue.
Discussion: Socially vulnerable patients with IBD are more likely to experience moderate-to-severe abdominal pain, joint pain, and fatigue compared to less vulnerable individuals. Future studies should focus on identifying gaps in care and underlying factors that lead socially vulnerable patients to experience more pain and fatigue in order to address these disparities and improve healthcare utilization.
Disclosures:
Jessica Sheehan indicated no relevant financial relationships.
Molly Stone indicated no relevant financial relationships.
Laura Johnson indicated no relevant financial relationships.
Shirley Cohen-Mekelburg indicated no relevant financial relationships.
Peter Higgins: AbbVie – Grant/Research Support. Connectome Coordination Facility – Grant/Research Support. GI Health Foundation – Consultant. Imedex – Consultant. Lilly – Consultant. National Institute of Health and Takeda – Grant/Research Support. Pfizer – Consultant. Takeda – Consultant. Vindico Medical Education – Consultant.
Jessica L. Sheehan, MD, MSc1, Molly Stone, MD1, Laura Johnson, BS1, Shirley Cohen-Mekelburg, MD, MS2, Peter Higgins, MD1. P0909 - Social Vulnerability is Associated With Pain and Fatigue in Patients With Inflammatory Bowel Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
