S623 Treatment Satisfaction and Quality of Life in Patients with Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation

Introduction: Chronic abdominal and bowel-related symptoms are associated with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC), and quality of life (QoL) is decreased in these patient populations. This analysis evaluated whether QoL of survey participants who met Rome IV criteria for IBS-C or CIC improved in those reporting satisfaction with over-the-counter (OTC) and/or prescription medications for symptom management. Methods: Self-reported data were collected from a large, nationwide survey of adults in the United States from August 2020 to December 2021. Participants who selected IBS, constipation, or diarrhea in the survey comorbid conditions checklist and met Rome IV criteria for IBS-C or CIC were matched 1:1 with controls who did not select those conditions. Participants with IBS-C and CIC were assigned to cohorts based on reported medication use including OTC only, prescription ± OTC, and linaclotide ± OTC. Overall satisfaction with control of bowel and abdominal symptoms were evaluated for each cohort on a 7-point scale ranging from extremely dissatisfied to extremely satisfied. QoL was assessed for participants who were satisfied with control of their bowel, abdominal, or both symptoms (bowel symptom responders, abdominal symptom responders, or both symptoms responders, respectively) compared to controls using the Veterans Rand 12-item health survey (VR-12) which scores a physical component (PCS), a mental component (MCS), and health utility (VR-6D). Results: Participants taking prescription medications for IBS-C and CIC were more likely to be satisfied with control of bowel or abdominal symptoms than participants taking only OTC medication (Figure 1). Overall, the IBS-C (n = 910) and CIC (n = 2533) groups reported significantly worse scores than the control groups for PCS, MCS, and VR-6D. There were no significant differences in MCS compared to control in participants with IBS-C or CIC taking linaclotide who were satisfied with control of their bowel, abdominal, or both of their symptoms (Table 1). Conclusion: IBS-C and CIC were associated with worse QoL. However, participants taking prescription medications such as linaclotide, who reported being more satisfied with their symptom management compared to participants taking OTC alone, had better mental health scores, which was comparable to controls. These findings indicate that satisfactory management of IBS-C/CIC with prescription medications may restore declined QoL.Figure 1.: Satisfaction with the control of (a) abdominal symptoms in IBS-C, (b) bowel symptoms in IBS-C, (c) abdominal symptoms in CIC, and (d) bowel symptoms in CIC. Table 1. - Quality of life: IBS-C or CIC and responder cohorts versus controls Control IBS-C or CIC Cohort Prescription ± OTC Linaclotide ± OTC Bowel Symptom Respondera Abdominal Symptom Respondera Both Symptoms Respondera Bowel Symptom Respondera Abdominal Symptom Respondera Both Symptoms Respondera IBS-C, Nb 910 910 106 116 89 22 21 17 VR-12 MCS, mean (SD) 44.5 (12.2) 38.0** (12.5) 43.2 (11.4) 42.8 (11.4) 43.8 (11.3) 42.9 (13.1) 44.1 (12.8) 45.0 (12.6) VR-12 PCS, mean (SD) 45.6 (10.3) 41.2** (10.7) 42.0** (9.5) 42.2** (9.3) 42.5* (9.4) 42.2 (12.8) 43.1 (12.3) 42.3 (13.3) VR-6D, mean (SD) 0.68 (0.12) 0.61** (0.11) 0.64** (0.11) 0.64** (0.11) 0.65* (0.11) 0.65 (0.15) 0.67 (0.14) 0.67 (0.15) CIC, Nb 2533 2533 381 387 315 55 50 41 VR-12 MCS, mean (SD) 45.0 (12.4) 40.1** (12.3) 43.2* (9.9) 43.1* (10.2) 43.7 (9.8) 44.6 (10.8) 45.4 (11.4) 45.0 (11.2) VR-12 PCS, mean (SD) 45.8 (9.9) 40.9** (11.2) 40.3** (10.1) 40.2** (10.0) 40.3** (10.1) 40.1** (12.6) 39.6** (12.5) 40.5** (12.7) VR-6D, mean (SD) 0.69 (0.12) 0.62** (0.11) 0.63** (0.10) 0.63** (0.10) 0.63** (0.10) 0.64* (0.12) 0.64* (0.12) 0.64* (0.12) *Significance ≤0.05; **Significance ≤0.001. Significances compare to the control group.aParticipants were classified as a responder if they reported being satisfied (satisfied, very satisfied, or extremely satisfied on a 7-point scale) with control of bowel-movement-related symptoms (bowel symptom responder), control of abdominal symptoms (abdominal symptom responder), or control of bowel movement-related and abdominal symptoms (both symptoms responder). bOnly participants who answered this question were included. CIC, chronic idiopathic constipation; IBS-C irritable bowel syndrome with constipation; MCS, Mental Component Summary score; OTC, over-the-counter; PCS, Physical Component Summary score; SD, standard deviation; VR-12, Veterans RAND 12-item.