P581 Patient-reported complementary and alternative medicine use in IBD: 10 years of observation among patients included in a national cohort

Abstract

Background: Complementary and alternative medicines (CAM) may be defined as treatments that fall outside of conventional healthcare. Patients with IBD often turn to CAM, mainly without discussing it with their physician. We repetitively collect information on patientreported CAM use in 2007-2016. The aims of this study were to assess main types of CAM used by year and factors associated with CAM use in 2016. Methods: The Swiss IBD cohort started Nov 2006. At enrolment and annually, patients were asked to complete self-reported questionnaires (Q). CAM were collected using a list of previously identified CAM + a free text option. Cohort data were used to characterise CAM users. For descriptive purposes, we classified CAM using recommendations of the US National Center for Complementary and Integrative Health. Changes in life habits (e.g. diet, sportive activities) was taken as an additional category. Dietary and nutritional supplements were not assessed here. Logistic regressions were performed to search for factors associated with CAM use (i.e. ≥1 CAM reported from 2007 to 2016). Results: A total of 2657 patients filled ≥1 Q. Overall, CAM were used by 21.7% to 29.3% of patients over years. Types of CAM were natural products and biologically based therapies (range: 6.9-11.9%), change in life habits (6.2-11.2%), whole medical systems and traditional medicines (5.8-9.6%), mind-body interventions (3.2-7.7%), body-based interventions (3.5-6.9%) and energy therapies (1.9-4.6%). When looking to CAM use by patients in 2016, we found that 41.9%/44.4% of CD/UC patients used ≥1 CAM; the most frequent were “change in life habits” (20.6% of 18.7%), homeopathy (12.5% of 14.5%) and acupuncture (9.2% of 10.5%). No significant CAM differences were observed by type of disease, except for bioelectromagnetic therapies (3.5% for UC, 1.9% for CD; p = 0.010). CAM use in CD was significantly higher among women (OR = 1.9; p < 0.001), French-speakers (OR = 1.5; p = 0.002), patients with arthritis complications (OR = 1.5; p = 0.001) and lower among smokers, patients with higher SF-36 mental scores, higher age at diagnostic and B1p disease behaviour profiles. CAM use in UC was significantly higher among women (OR = 2.3; p < 0.001), patients with arthritis complications (OR = 1.4; p = 0.017), aged 36-45, and lower with increased IBD QoL score. Conclusions: Each year, >1 of 4 of IBD patients used CAM, with no major changes in CAM types. Forty-three patients reported ≥1 CAM use in 2016. Factors associated with CAM use differed between UC and CD. Some of them seem to be linked with relieving articular and musculoskeletal pain or improving QoL.