Assessing disease control in inflammatory bowel disease: a real world cross-sectional study in the UK (PODCAST-IBD).

Proportion Of suboptimal Disease Control And Strategy of Treatment in IBD (PODCAST-IBD) was an international real-world study which aimed to quantify disease control in IBD using STRIDE-II recommendations. Cross-sectional assessment of IBD patients attending routine clinic appointments in four UK centers October 2022 to January 2023. Clinician-reported outcomes, patient-reported outcomes and retrospective data from medical chart review were used to assess IBD control against red flags aligned to STRIDE-II. Data were available from 198 UK patients. IBD was suboptimally controlled in 52.4% (54/103) of patients with Crohn's disease (CD) and 45.3% (43/95) with ulcerative colitis (UC). Impaired quality of life (QOL), defined as Short inflammatory bowel disease questionnaire (SIBDQ) score <50, was the main contributor to suboptimal disease control. Suboptimal disease control has a detrimental impact on fatigue and disability with significantly lower mean Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) score in suboptimally controlled disease (CD: 81.5 vs 125, UC: 87.4 vs 122.8) and IBD Disk. Suboptimal disease control results in higher health care resource use (HCRU) (CD: £4,746 vs £1,924; UC: £2,428 vs £1,121) and higher rates of work productivity loss (CD: 41.7% vs 11.9%, UC: 38.0% vs 22.6%). IBD was suboptimally controlled in around one-half of patients. Impaired QOL was the most common contributor (64%, 62/97) to suboptimal control. Suboptimal control had a considerable economic impact; HCRU more than doubled and productivity fell. Physicians could consider regular QOL assessments to prompt timely disease monitoring to enable identification of early active disease and appropriate treatment. Inflammatory bowel disease (IBD), which encompasses Crohn's disease (CD) and ulcerative colitis (UC), is a life-long, painful and debilitating disease. Symptoms include abdominal pain, diarrhea and extreme tiredness (fatigue) and may also affect the eyes, joints and skin. People with IBD have periods of time where their symptoms are not controlled (known as relapse), with minimal symptoms (known as remission) at other times. This paper reports on people from the UK who participated in the wider international PODCAST-IBD study. The PODCAST-IBD study used information from people with IBD, their doctors and their medical notes to assess how well IBD was controlled and the impact of suboptimal disease control on their lives and use of healthcare. Overall, IBD was suboptimally controlled in around one-half of the people with IBD: 52.4% (54/103) of those with CD and 45.3% (43/95) with UC. Reduced quality of life (QOL) was the most common contributor to suboptimal control with almost two-thirds of people reporting impaired QOL. Suboptimal control of IBD impacts on people’s everyday life – resulting in fatigue and disability, reducing QOL and making it difficult to work. Suboptimal control of IBD also has a considerable economic impact since it results in increased healthcare use. It might be helpful for doctors to consider regular QOL assessments to help to identify those people whose IBD is not well controlled to ensure that they receive appropriate treatment to control disease and improve their lives.