UNDERSTANDING HOW PATIENTS WITH MODERATE-TO-SEVERE ULCERATIVE COLITIS DESCRIBE THE SPECTRUM OF BOWEL URGENCY DEFINITIONS: RESULTS FROM QUALITATIVE RESEARCH

Abstract BACKGROUND Bowel urgency, the sudden or immediate need to have a bowel movement, is a burdensome symptom to patients with ulcerative colitis (UC). The objective of this study was to understand how adult patients with moderately-to-severely active UC describe bowel urgency remission and “no or minimal” bowel urgency. METHODS Qualitative phone interviews were conducted with adults with HCP-confirmed moderately-to-severely active UC. The interview included open-ended questions that elicited participant perceptions of bowel urgency remission, “no or minimal” and “normal” bowel urgency. Participants indicated which score on the 11-point Urgency Numeric Rating Scale (Urgency NRS; 0 [no urgency] to 10 [worst possible urgency]) they would use to describe “no or minimal” and “normal” bowel urgency. Participants were recruited from 6 clinical sites based in the United States. ATLAS.ti was used to organize the data. Descriptive statistics were used for sociodemographic and clinical characteristics. RESULTS 19 adults with moderately-to-severely active UC participated in this study. Participants had a mean age of 48.1 years, 63% were female, 74% were white, and 58% were employed full-time. All participants had experienced bowel urgency and 79% (n=15/19) confirmed they had experienced a bowel-urgency related accident in the past. Most participants (n=18/19; 95%) defined bowel urgency remission as “feeling normal” with fewer bowel movements and reduced levels of bowel urgency and 4 participants (21%) defined bowel urgency remission as having a “good day” (Table 1). The impact of bowel urgency remission included the ability to partake in social/leisure activities and feeling less anxious overall (Table 2). Participants selected scores from 0 to 5 on the 11-point Urgency NRS to describe “no or minimal” bowel urgency with 5 (26%) indicating that “0 to 4” was the appropriate range, whereas 5 (26%) selected “0 to 2”. Other participants selected “0 to 3” (n=3/19; 16%), “0 to 1” (n=2/19; 11%), “0” (only) (n=2/19; 11%), “1 to 2” (n=1/19; 5%), and “0 to 5” (n=1/19; 5%). The majority of participants (n=15/19; 79%) described feeling “normal” and having minimal impacts when experiencing “no or minimal” bowel urgency. Participants were also asked to indicate the highest score on the Urgency NRS at which they could still consider their bowel urgency to be “normal” and 42% of participants (n=8/19) selected 5 as the highest score that they would still consider as “normal.” CONCLUSION These interviews provided evidence that among patients with moderately-to-severely active UC, bowel urgency can still be considered “no or minimal”, “normal” or in “remission” even when some amount of bowel urgency is present. In general, responses of “0” to “5” on the Urgency NRS were considered to correlate to “no or minimal” or “normal” bowel urgency.