Evaluation of the Symptoms and Clinical Characteristics of Crohn's Disease and Ulcerative Colitis That Affect Healthcare Providers' Treatment Choices

Background: Treatment of inflammatory bowel disease-Crohn's disease (CD) and ulcerative colitis (UC)-is dependent on healthcare providers' (HCPs') clinical assessment of patient symptoms. We therefore evaluated which CD and UC symptoms impact HCPs' treatment choices and assessed the impact of those symptoms on treatment decision-making. We also examined the role of complete control (mucosal/histologic healing, clinical remission, no bowel urgency) in treatment decision-making, considerations for dose escalation or switching treatments, and HCPs' willingness to use the Urgency Numeric Rating Scale (NRS) to assess bowel urgency severity.

Methods: We conducted an observational, cross-sectional, self-administered survey among HCPs (N = 459, across types/specialties) who work in direct patient care and treat patients with CD and UC in the United States. Data were collected from eligible participants between November 21, 2022, and December 6, 2022, and responses were summarized through descriptive statistics.

Results: For CD and UC, the symptoms of greatest importance when deciding on the course of treatment included cramping or abdominal pain, rectal bleeding, diarrhea, anemia, weight loss, and bowel urgency. Furthermore, most HCPs ranked rectal bleeding, clinical remission, abdominal pain, and complete control as "very" to "extremely" important in decisions about the course of treatment, dose escalation, or switching treatments. In total, 22.9% of HCPs indicated that they use the Urgency NRS, while 89.3% were at least somewhat willing to use it in the future.

Conclusions: Our study provides real-world insights into the symptoms and clinical characteristics that most impact HCPs' treatment choices for CD and UC in clinical practice.