A119 UNDERSTANDING THE PERSPECTIVES OF PATIENTS WITH LOW EDUCATIONAL ATTAINMENT IN IBD: RESULTS OF A QUALITATIVE STUDY

Patients from lower vs. higher socioeconomic classes may have less opportunity to participate in health research due to: less flexible work hours, working multiple jobs, less likely to be self-employed, less education and lower understanding of the importance of research. To increase our understanding of the concerns and preferences for care of patients with inflammatory bowel disease (IBD) with less than a university degree. A cross-sectional study was undertaken at the McGill University Health Centre IBD Clinic (July-August 2018). Inclusion criteria were: out-patients, aged 18 years or older, English- or French-speaking, less than a university degree and diagnosed with ulcerative colitis or Crohn’s Disease for at least one year. A research assistant conducted semi-structured interviews using a questionnaire that addressed: 1) characteristics of health care providers and the system, 2) what health care providers do in delivering care and 3) patient outcomes and goals. The questionnaire was created based on a focus group guide that had been developed for our larger study aimed at eliciting patient preferences for care in IBD. Descriptive statistics were used to characterize the study population and to quantify the number of participants who endorsed various elements of care. Qualitative data were analyzed by identifying themes and selecting exemplars to support them. In total, 23 individuals (median age=41; 12 females) participated, of whom 21 (91.3%) did not attend university and 2 (8.7%) attended university without completion. Fifteen (65.2%) participants rated access to an IBD specialist as the most important aspect of care; 8 (34.8%) and 9 (39.1%) participants said holistic and complementary and alternative medicine, respectively, were important for their care. The 3 most commonly reported experiences in the health care system were: good care (52.2%), lengthy delay until diagnosis (26.1%) and non-receptive staff (13.0%). The 3 most commonly reported experiences with health care providers were: kind staff (34.8%), receptive IBD doctor (26.1%) and non-receptive IBD doctor (21.7%). The 3 most helpful aspects in managing IBD were: IBD specialist, family and friends and treatment that reduces symptoms. The 3 most difficult aspects of living with IBD were: urges/pain/anxiety, social aspect and medications and side effects.The top-ranked goal was reducing symptoms. Access to a receptive IBD specialist was the most important aspect of receiving good quality care. Many patients used a multidisciplinary approach to achieve disease remission that included use of non-traditional therapies. These findings may be used to enhance the quality of patient care. THEMES & EXEMPLARS Most helpful in managing disease Ferring Canada

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