S1095 Reduction in Gastrointestinal Visits and Portal Messaging Following Tenapanor (IBSRELA) Initiation for Community Gastrointestinal Patients

Introduction: Irritable bowel syndrome with constipation (IBS-C) is a chronic disorder of gut-brain interaction (DGBI) associated with high healthcare resource utilization (HCRU). Tenapanor (TEN [IBSRELA]) is a first-in-class, minimally absorbed inhibitor of intestinal sodium/hydrogen exchanger isoform 3 approved for the treatment of IBS-C in adults. An electronic health records (EHR) study is ongoing to understand the real-world use and outcomes of IBS-C medications in community gastrointestinal (GI) practices. Here, we report findings for within-patient changes in GI-related HCRU following TEN initiation for the treatment of IBS-C. Methods: This observational study used EHR data from patients treated at a large medical group of approximately 350 gastroenterology providers serving over 6 million patients across 7 states. Eligible patients were aged ≥18 years, had a diagnosis of IBS, had ≥1 visit within the 365 days before initiating TEN, and initiated TEN ≥365 days prior to the EHR data pull. The within-patient change in clinical encounters and portal message activity was calculated by comparing utilization in the 365 days before versus after TEN initiation. Within-patient change in HCRU was stratified by tertile of pre-TEN HCRU. Results: The study included 712 patients, of whom 86% were women, 44% were Medicare eligible, and the average age was 48 years. Overall, the median within-patient change in GI visits after TEN initiation was −1 (quartile [Q]1: −2, Q3: 0) for regular visits and 0 (Q1: −3, Q3: 1) for labs. High utilizers (≥4 pre-TEN clinical encounters) had substantial reductions in regular visits (median change: −3, Q1: −4, Q3: −2) and labs (median change: −4, Q1: −7; Q3: −3) after TEN. Portal message activity also decreased in high utilizers (≥10 portal messages or ≥606 message words): number of messages (median change: −6, Q1: −19, Q3: 2) and words in messages (median change: −531, Q1: −1059, Q3: 54). Changes in clinical encounters and portal message activity after TEN were limited among low and moderate utilizers. Conclusion: These preliminary findings indicate that GI-related clinical encounters and patient portal message activity substantially decreased after TEN initiation among patients with high pre-TEN HCRU in each category. This suggests that TEN may reduce burden on the healthcare system and patients by reducing high HCRU, potentially leading to cost savings.