A MULTICENTER, OBSERVATIONAL STUDY OF A QUESTIONNAIRE SURVEY ON ANXIETY AND BEHAVIORAL CHANGES FELT BY JAPANESE PATIENTS WITH INFLAMMATORY BOWEL DISEASE DUE TO COVID-19 EPIDEMIC

ABSTRACT

Background: Inflammatory bowel disease (IBD) is a disease with repeated relapses and remissions, and it is considered that IBD patients had more than a little conflict between the threat of COVID-19 infection by visiting the doctor and the anxiety about their own disease by postponing the visit. We investigated the impact of the COVID-19 pandemic on the anxiety and behavioral changes of Japanese IBD patients. Methods: We collected questionnaires from 3032 IBD patients aged 16 years or older attending 31 facilities in Japan between March 2020 and June 2021. The primary endpoint was anxiety felt by IBD patients during the COVID-19 pandemic. Results: The median age was 44 years;43.3% of the participants were female. 60.6% of the participants was diagnosed with ulcerative colitis and 39.4% with Crohn’s disease (CD), and the median disease duration was 10 years. Regarding IBD medications, about 80% of the patients were taking 5-ASA, followed by thiopurine (31.4%), biological agents (47.4%), and less than 10% of the patients were taking steroids or budesonide. 37.7% of participants reported that they were in clinical remission, whereas 35.6% were in mild and 19.3% were in moderate activity. The questionnaires were collected throughout the middle of the second wave to the end of four waves of COVID19 in Japan. The mean VAS score is 5.1±2.5 during this pandemic, which indicated moderate anxiety. The most frequent causes of anxiety were the risk of SARS-CoV-2 infection by visiting hospital, the risk of infection by IBD itself, and the risk of infection by IBD medication. Factors associated with anxiety are women, housewives, time to visit hospital, transportation by train, use of immunosuppressive drugs, and nutritional therapy. The results of the questionnaire survey on medical visits showed that about 90% of the patients went to the hospital and received treatment as scheduled. During this pandemic, 97.5% of the patients continued oral medication and injections as physicians indicated. Most of participants felt the need for a family doctor and primarily sought guidance, and information regarding SARS-COV-2 from television or internet news. 35.6% of the patients were given information about prevention of SARS-COV-2 by their physicians. 42.6% of the patients received an explanation about the continuation of medication from their physicians. Conclusion: Japanese IBD patients had moderate disease-related anxiety. The percentage of patients with a behavioral change was small. Based on the content of anxiety obtained in this study, we should continue to proactively inform patients about infectious diseases such as SARS-COV2 and the accompanying accurate information related to IBD management, thereby relieving their anxiety. (Figure Presented)