P2590 - Negative Illness Perceptions are Associated With Clinical Disease Activity in Adult Patients With Inflammatory Bowel Disease

David Bickford, MD¹, Emily Sheng, BA¹, Melissa G. Hunt, PhD², Sara N. Horst, MD³, Samir A. Shah, MD⁴, Sumona Saha, MD, MS⁵, Sasha Taleban, MD⁶, Lily Brown, PhD¹, Kanika Malani, BS⁷, Megan Lutz, MD⁸, Hannah Fiske, MD⁹, Robert Kuehnel, PhD¹, Brittaney Bonhomme, BA¹, Alandra Weaver, MPH¹⁰, Millie D. Long, MD, MPH¹¹, Raymond Cross, MD¹², James Lewis, MD, MSCE¹³, Chung Sang Tse, MD^2
1Hospital of the University of Pennsylvania, Philadelphia, PA; ²University of Pennsylvania, Philadelphia, PA; ³Vanderbilt Inflammatory Bowel Disease Clinic, Nashville, TN; ⁴Gastroenterology Associates, Inc., powered by GI Alliance, Providence, RI; ⁵University of Wisconsin Hospitals and Clinics, Madison, WI; ⁶University of Arizona, Tucson, AZ; ⁷The Warren Alpert Medical School of Brown University, Providence, RI; ⁸University of Wisconsin-Madison, Madison, WI; ⁹Brown University / Rhode Island Hospital, Providence, RI; ¹⁰Crohn's and Colitis Foundation, New York, NY; ¹¹Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC; ¹²University of Maryland School of Medicine, Baltimore, MD; ¹³Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA

Introduction: Illness perceptions are emotional and cognitive beliefs that may influence a person’s psychological coping, health behavior, and chronic disease course. However, there is a knowledge gap for how illness perceptions are associated with disease activity in adults with inflammatory bowel diseases (IBD).

Methods: We conducted a mixed-methods survey study on adults with IBD from five geographically diverse gastroenterology practices participating in the Crohn’s and Colitis Foundation’s Clinical Research Alliance’s ADEPT Trial (NCT05635292). We used multivariable logistic regression models to assess for associations between negative illness perceptions and clinical disease activity (2-item patient-reported outcome, PRO-2), adjusted for age, gender, and IBD subtype. The Brief Illness Perception Questionnaire (BIPQ) assesses eight cognitive and emotional representations of IBD (0-5 Likert scale, cut points at >75th interquartile for negative illness perceptions, with reversed coding for positively worded items) and an open-ended question on patients’ personal beliefs on the causes of IBD, assessed by qualitative thematic analysis.

Results: In 649 adults (62% female; median age 38 years, 63% Crohn’s disease), 45% had clinically active IBD, which was associated with negative illness perceptions, particularly IBD’s impact on their lives (consequence: aOR 4.8, 95% CI 3.2-7.4), lower treatment effectiveness (treatment control: aOR 2.3, 95% CI 1.4-3.0), more severe symptoms from IBD (identity: aOR 9.3, 95% CI 5.5-15.9), more concern about IBD (concern: aOR 3.8, 95% CI 2.5-5.8), and feeling angry, scared, upset or depressed because of IBD (negative emotional response: aOR 3.4, 95% CI 2.2-5.4) (all p< .001 on univariate and multivariable analyses; Table 1).

On thematic analysis, patients most often believed that IBD was caused by stress (25% of all themes), diet (21%), genetics (18%), lifestyle (7%, including sleep, exercise, substance use), or was a secondary effect of another illness or medical event (5%, including consequence of another illness, medication, or pregnancy).

Discussion: Negative illness perceptions are associated with clinically active disease in adults with inflammatory bowel diseases. Psychosocial interventions that target negative illness perceptions, such as cognitive behavioral therapy and patient-centered information on the etiology of IBD, may be an effective adjunct therapy in adults with active IBD.


Disclosures:


David Bickford, MD¹, Emily Sheng, BA¹, Melissa G. Hunt, PhD², Sara N. Horst, MD³, Samir A. Shah, MD⁴, Sumona Saha, MD, MS⁵, Sasha Taleban, MD⁶, Lily Brown, PhD¹, Kanika Malani, BS⁷, Megan Lutz, MD⁸, Hannah Fiske, MD⁹, Robert Kuehnel, PhD¹, Brittaney Bonhomme, BA¹, Alandra Weaver, MPH¹⁰, Millie D. Long, MD, MPH¹¹, Raymond Cross, MD¹², James Lewis, MD, MSCE¹³, Chung Sang Tse, MD². P2590 - Negative Illness Perceptions are Associated With Clinical Disease Activity in Adult Patients With Inflammatory Bowel Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.