(P011) RACIAL DISPARITIES ON ACCEPTANCE OF BIOLOGIC AND SMALL MOLECULE THERAPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A SURVEY STUDY

Background: Inflammatory bowel disease (IBD) has a worldwide impact. However, there is limited research on racial disparities in accessing and receiving various medical therapies for IBD. Our study aims to determine any racial disparities in acceptance of biologics and small molecule therapy for Asian, White, and Black patients with IBD.

Methods: We conducted a survey-based study among self-identifying Asian, Black, and White patients with moderate-severe IBD on their perspectives of biologic and small molecule therapy. The survey was piloted among 10 patients. Forward-backward translation was performed in Chinese and a Mandarin/Cantonese speaker (AS) administered the survey for non-English speaking patients. Moderate-severe IBD was defined as 1 of these criteria: receiving ≥1 prescriptions of steroid, thiopurine, biologic or small molecules in the last 6 months; ≥1 IBD-related hospitalization or surgery in the last year, ≥1 clinic visit discussing initiation of biological or small molecules in the last year; symptomatic despite current medical regimen in the last year. Patients among the three racial groups were matched for disease type (Crohn’s disease or ulcerative colitis), age, and sex. The survey included 35 statements and used a 5-point Likert scale to measure responses on topics including beliefs about medication and health, medication access, and language barriers. A one-way ANOVA was performed to compare the means of each survey answer between different racial groups.

Results:

A total of 26 Asian, 26 White, and 19 Black patients participated in the survey. Asian and Black patients were less likely to trust their doctors in prescribing medications that would help them compared to White patients (p=0.020). Asian and Black patients believed their doctors put too much trust in medications compared to White patients (p=0.040). White patients were more likely to prefer their physician to speak their language (p=0.049). Asian patients were more likely to experiences language barriers including: “Language makes it hard to understand how medication works” (p=0.029); “Language makes it hard to understand the side effects” (p=0.005); “Language makes hard to share about my disease” (p< 0.001); “I use the interpreter services” (p< 0.001) (Table 1).

Discussion:

In conclusion, Asian and Black patients had statistically higher mistrust in biologic and small molecule therapy. Asian patients faced statistically significant increased challenges in understanding how biologic or small molecule medication worked, side effects of these medications, and communicating to their physician about their disease. Physicians should keep these perspectives in mind when discussing biologic and small molecule medications for IBD patients of different racial backgrounds.