Health Disparities in the Care of Patients With Inflammatory Bowel Disease: A Focus on Preventive Care & the Patient Perspective

Introduction: Management of patients who suffer from Inflammatory bowel disease (IBD) requires preventative care. This high-quality care offered to patients improves health outcomes. Racial and ethnic minority IBD patients, as well as individuals from low socioeconomic backgrounds have been increasingly recognized to be affected by health disparities in chronic disease management. Thus, the aim of this study is to better understand disparities in care between Black and White IBD patients, with a focus on preventative health measures, while also integrating the patient’s perspective of their care. Methods: A 34-question web-based patient survey that included demographic, diagnostic, treatment, and quality of life-related questions was conducted. The survey was made available through a database of IBD patients previously identified as potential clinical trial participants. The survey included 22 questions with closed answers, 10 questions with the opportunity to select "other" and provide additional information, and 2 open-ended questions. Results: Approximately 2000 patients accessed the survey email. The survey respondent rate was nearly 25%, with data from 455 patients who completed the survey included in this analysis. Of those who completed the survey, 415 (91.2%) were White and 40 (8.8%) were Black (Figure 1). In terms of preventive screenings, skin cancer screening was discussed with 26.8% of all IBD patients, and was discussed with 28.2% of White patients, compared to only 12.5% of Black patients (P = 0.047). The least frequently discussed topic amongst all IBD patients were pap smears (13.7% for White respondents, 12.5% for Black respondents). There was no statistically significant difference by race in discussions around pap smears, mental health, vaccinations, bone heath, nutrition, or cancer prevention between Black and White IBD Patients. Conclusion: We found that health care providers infrequently discuss preventative care for IBD with their patients. In our study, the least commonly discussed health care measure by providers were pap smears. From the patient’s perspective, to improve the relationship between Black patients and their providers, a trusting, empowering, and respectful environment should be established. Provider self-awareness including understanding their communication style is crucial when cultivating these interactions. Patients want to be able to take an active role in their care and feel empowered by their physicians to do so.Figure 1.: Participants responses about discussions on preventive maintenance with their healthcare providers.