S1137 Healthcare Utilization Patterns in Patients With Irritable Bowel Syndrome and Association With IBS-specific Quality of Life (IBS-QOL) Measures

Introduction: Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut brain interaction (DGBI) with negative impact on quality of life (QOL), the primary driver of increased healthcare utilization (HCU). A prior prospective study showed that IBS-specific QOL (IBS-QOL) was reduced across racial groups. The aim of this study was to compare measures of HCU between IBS patients and non-IBS controls in that cohort. Methods: Patients with confirmed IBS (by Rome III) and non-IBS controls from the prospective study cohort were enrolled. Questionnaires for IBS- QOL were completed. Clinical data were collected retrospectively from 2002 to 2015. Measures of HCU included number of office visits, endoscopic procedures, GI referrals, hospitalizations, and abdominal surgeries. Chi-square, Fischer’s exact, 2-tailed t-test, and multiple logistic regression analysis were used. Results: A total of 253 participants were enrolled (IBS, N = 72; non-IBS controls, N = 181). Basic demographics of participants who underwent EGD and colonoscopy (CLS) for IBS and non-IBS patients were similar except the age distribution for the CLS comparison. Regression modeling also showed age was the only significant factor associated with the outcome (P < 0.0001), in contrast to race (P = 0.1), gender (P = 0.5), BMI (P = 1.0), and smoking (P = 0.6). Total and IBS-related GI and PCP visit numbers were significantly higher in the IBS group (P < 0.0001), and PCP visits when related to IBS symptoms, were significantly higher in the IBS cohort (P < 0.005). In both IBS and control groups, increased HCU showed weak to moderate negative correlations with several QoL domains, particularly dysphoria, health worry, relationship, and social reaction. These associations were more pronounced in the IBS cohort, with GI visit frequency showing a stronger inverse relationship with dysphoria and health worry scores. Other measures of HCU did not differ across racial groups except for abdominal surgeries. Conclusion: In this cohort, HCU is significantly higher in IBS patients as compared to non-IBS control participants as measured by office visits and is disparate across racial groups. GI visit frequencies show a moderate inverse relationship with dysphoria and health worry scores in contrast to non-IBS controls suggesting that visit volume may reflect greater symptom burden among IBS patients. Management of IBS should aim to improve QOL to reduce HCU taking into account racial differences.