P646 The Loss of Productivity in Employment and Education Associated to Inflammatory Bowel Diseases: A Pilot Study of the Patient’s Perception

Background Inflammatory Bowel Diseases (IBD) impact vocational, educational, and psychosocial aspects of a patient’s life and may cause patients to miss work or school or underperform. This study describes loss of productivity in Hispanics with IBD in the workplace and educational settings, along with the patient’s perception. Methods Patients with IBD attending a tertiary care clinic were given a self-administered survey related to loss of productivity in employment and education. The questionnaire acquired qualitative and quantitative data about the patients’ past and present work and educational settings. Productivity was determined by the number of absences or early leaves from school or work due to disease manifestations. The patient’s perception regarding psychological aspects of their condition was assessed. Descriptive statistics were used for sociodemographic data, perceptions regarding their condition, and clinical history as captured by the questionnaire. This study is approved by the MSC IRB. Results 100 patients (M/F: 50/50, CD/UC: 72/28, age range: 18–61, mean age: 29.78 ± 9.81) participated. 45 participants were working, 16 were studying, and 25 were working and studying. 89% of those working had to leave early or miss work due to disease manifestations and, among those, 51% had more than two absences in a given month. During their school years, 100% had absences or had to leave class early because of the disease. 61% said that their condition has a negative effect in their daily lives. Furthermore, 61% perceived their disease affects moderately to severely their daily life. However, 61% expressed that their disease has minimal or no effect on their self-esteem, 75% denoted that their disease does not impact their familial relationships and 74% indicated that they manage their disease with a positive mindset. There was no significant association between sex (p=0.71) or diagnosis (p=0.31) and perception of disease severity. Conclusion Work and study absences due to IBD manifestations were frequently reported in the study, translating into decreased productivity. Perception of disease severity was independent of diagnosis and sex. A majority perceived that IBD affected daily life moderately to severely. Strategies to improve work and study conditions may result in improved productivity.

Well-being and disease severity of multiple sclerosis patients following a physical activity program

Introduction: Multiple sclerosis (MS) is a chronic disease of the central nervous system that mainly affects young adults, promoting a great impact on functionality. Fatigue is a very common symptom, associated with multiple impairments in sensitivity, muscle activity, neuromotor control, balance, cognition and problem-solving ability. MS leads to strong functional restrictions, particularly in the context of daily living activities, as well as in patient participation. Objective: To understand the implications of a self-regulation program in the perception of well-being and mental health in MS patients. Methods: A set of exercises was implemented for use in daily activities, supported by different studies with MS patients. Patients were asked to classify the severity of their disease and to use the Mental Health Inventory (MHI-38), at the beginning (time A) and at the end (time B) of the self-regulation program. We used the Statistical Package for the Social Sciences (SPSS) version 25. A non-parametric statistical hypothesis test (Wilcoxon test) was used to analyze the variables. Results: The mean age was 44 years old, with patients between the ages of 20 and 58. 58.3% were women, 37.5% were currently married, 67% were retired and the mean level of education was 12.5 years. The correlation between the perception of disease severity and psychological well-being before the self-regulation program (r = 0.26, p < 0.05) and after the intervention (r = 0.37, p < 0.01) suggests a low to moderate correlation. Conclusion: The implementation of the self-regulatory model, through the promotion of physical activity in patients with MS, had a positive impact of clinical rehabilitation, well-being, and perception of disease severity of these people.

COVID-19 is viewed as severe as Tumor and HIV; Perceptions towards Covid-19. (Preprint)

UNSTRUCTURED COVID-19 pandemic has killed thousands and still does. Since its first emergence, people have been having different attitudes and perceptions towards the virus. Perceptions have profound consequences on behavior. For example, patient’s perception of disease threat (disease severity) leads to medication adherence. COVID-19 perception studies guide public awareness efforts or help in understanding behavior, yet limited. This study responds that call, offers a glimpse. A repeated cross-sectional data is collected from 376 randomly selected respondents located all over the world in two periods. Perceived severity (how severe people think COVID-19 and 16 other illnesses are), perceived disease belongingness (rating of COVID-19 and 16 other illnesses as mental or physical) and demographic variables (gender, age and education) are measured. ANOVA, Spearman correlation and scatter analysis are applied. Perceived severity, perceived disease belongingness and age correlate between each other. Participants perceive COVID-19 as severe as Tumor and AIDS (F (2,722) =2.347; p=.096), and as more severe than other 14 illnesses; e.g. Diabetes and High blood pressure. Age wise, participants above 50 age group perceive COVID-19 as more severe than the under 50 (F (1,240) = 10.378, p <.001). A month later, depression surpassed COVID-19 to be perceived as more severe. Majority of respondents attribute COVID-19 as a physical (vs mental) illness, thus consider it severe (vs not severe). Implications could mean; (1) COVID-19 patients might be susceptible to social stigmatization as HIV patients, (2) stay-home obligations are possibly exposing to depression and (3) severity perception is shaping intervention friendly behaviors.

FRI0042 DISCREPANCIES BETWEEN RAPID3 AND DAS28 IN RHEUMATOID ARTHRITIS PATIENTS IN REMISSION OR LOW DISEASE ACTIVITY RECEIVING TNF INHIBITORS: WHAT IS THE ROLE OF THE INFLAMMATION BIOMARKERS?

Background:Patients and Rheumatologist often differ in their perception of RA disease activity. Remission or low disease activity should be the treatment target in RA, patients should be included in treatment decisions.Objectives:To identify factors influencing patient’s self-reported disease activity by RAPID3 test.Methods:47 RA patients in remission or low disease activity by DAS28ESR (DAS28ESR ≤ 3.2) receiving TNFi (etanercept, adalimumab and infliximab) stratified their disease activity by RAPID3, then two patients’ groups were defined:target group(RAPID3 with remission 0-3 or low disease activity 3.1-6),non-target group(RAPID3 with moderate 6.1-12 or high disease activity >12). Demographic data, disease duration, autoantibody status, radiological data, concomitant csDMARD therapy was collected. Laboratory measurements included CRP, ESR, calprotectin serum levels, TNFi trough serum levels, and antidrug antibodies (enzyme-linked immunosorbent assay (ELISA) test kit (Calprolab™ Calpro AS, Oslo, Norway, and Promonitor®, Progenika SA, Spain, respectively) according to the manufacturers’ protocol. Pearson´s correlations coefficients were used to identify variables correlating with RAPID3 score. Mixed-effects analyses of covariance (ANCOVAs) models were used to identify factors influencing RAPID3 score.Results:Patients in “target group”have shown a significant lower TJC, pain by VAS 0-10mm, and calprotectin serum levels, but higher TNFi serum trough levels in comparison to “non-target group”. When patients were classified according to RAPID 3 categories, patients in “remission” have shown lower calprotectin serum levels than those classified as in “high disease activity” (0.94 (4.88-0.14) vs. 4.57 (7.97-1.25),p=0.001, respectively). Accordingly, when classified according to pain by VAS 0-10mm, patients with low levels of pain had lower calprotectin serum levels vs. those with severe pain (1.43 (6.33-10.14) vs. 5.16 (8.80-1.25),p=0.009, respectively). When distributed according to PGA (1=very good, 2=good, 3=regular, 4=bad, 5=very bad) patients in “very good” group had lower mean of calprotectin serum levels than those in “very bad” group (0.94 (4.88-0.14) vs. 4.57 (7.97-1.25),p=0.001, respectively). PGA and Pain VAS have shown a strong correlation with RAPID 3 (R20.978, and 0.834,p=0.001, respectively), while calprotectin and TNFi serum trough levels showed a moderate correlation (R20.311, and 0.372,p=0.005, respectively). The multivariate adjusted analysis showed a significant association between Pain and RAPID3 (p<0.001) according to the different covariates (age, gender, anti-CCP positivity, time in remission, SJC, TJC, DAS28ESR). In addition, calprotectin and TNFi trough serum levels were associated with RAPID 3 (p<0.005). Backward selection of variables did not substantially modify the association between RAPID 3 and pain, calprotectin and TNFi trough serum levels.Conclusion:61.7% of RA patients undergoing TNFi classified as in remission or low disease activity by DAS28ESR, self-reported their disease activity as moderate or high by RAPID3. The most significant factor influencing patient’s perception of disease activity is pain (pain VAS and TJC). However, inflammation markers (calprotectin, TNFi serum trough levels) remain statistically significant after fully adjustment by different confounders. Thus, therapies improving these three domains will have a larger impact in patient´s perception of disease activity.References:[1]Studenic P, et al. Arthritis Rheum. 2012;64:2814-23.Disclosure of Interests:Jose Inciarte-Mundo Employee of: Eli Lilly, Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer, Rosa Morlà Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer, Beatriz Frade-Sosa: None declared, Julio Ramírez Speakers bureau: Abbvie, Eli Lilly, BMS, Roche, Novartis and Pfizer, Raul Castellanos-Moreira Speakers bureau: Lilly, MSD, Sanofi, UCB, Virginia Ruiz Speakers bureau: Lilly, Pfizer, Juan de Dios Cañete: None declared, José Gomez Puerta Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer, Raimón Sanmartí Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer