Deprescribing 5-Aminosalicytes in Patients with Ulcerative Colitis on Concomitant Advanced Therapy: A Qualitative...

Area of Science:

• Gastroenterology
• Clinical Pharmacy
• Patient-Reported Outcomes

Background:

• Current data suggests 5-aminosalicylic acid (5-ASA) may not impact outcomes in moderate to severe ulcerative colitis (UC) patients on advanced therapies.
• Discontinuation of 5-ASA in UC patients on advanced therapy is a potential strategy, but patient perspectives remain unevaluated.

Purpose of the Study:

• To explore patient experiences with 5-ASA treatment in combination with advanced therapy for UC.
• To identify barriers, facilitators, and patient attitudes toward deprescribing 5-ASA medications.

Main Methods:

• Qualitative evaluation using two focus groups with UC patients on stable 5-ASA and advanced therapy for at least six months.
• Analysis of patient satisfaction, therapy barriers, quality of life, and opinions on deprescribing.
• Iterative inductive/deductive approach for transcript analysis.

Main Results:

• Ten patients (average age 50, 50% female, 80% White) on tofacitinib, vedolizumab, or infliximab participated.
• Key themes included patient emotions, coping, quality of life, beliefs, condition experiences, and symptoms.
• Clinician themes involved endorsement, communication, patient relationships, information sharing, and readiness for deprescribing.

Conclusions:

• UC patients on advanced therapy are receptive to 5-ASA deprescribing.
• Key considerations for patients include assurance of sustained symptom control and the ability to restart 5-ASA if necessary.