Inflammatory Bowel Disease Care Barriers and Medication Beliefs in a Majority Hispanic Population: A Patient Survey

Data regarding barriers to inflammatory bowel disease (IBD) care in largely Hispanic populations is limited. This study evaluated barriers in Black/Indigenous/People of Color/Hispanics (BIPOC/H) and White/non-Hispanics (W/NH) with IBD.

An anonymous survey was administered to adult IBD patients at Keck Medical Center of the University of Southern California and Los Angeles General Medical Center between March and October 2024. Data included the Consumer Assessment of Healthcare Providers and Systems and Barriers to Care surveys, the Medication Adherence Rating Scale-4, and the Beliefs about Medicines Questionnaire. Analyses compared BIPOC/H and W/NH patients via X ² and t-tests.

Included were 172 of 195 eligible patients (88% response). Compared to W/NH patients, BIPOC/Hs reported delays of longer than 1 year in receiving a diagnosis, 49.6% versus 27.8% (P = 0.015) more IBD-related financial difficulty, 55.6% versus 22.2% (P = 0.001); more difficulty obtaining emotional support (56.4% vs. 33.3%, P = 0.05); and community support for IBD (45.0% vs. 20.0%, P = 0.004). BIPOC/H patients had higher mean worries about medication harm (13.7 vs. 11.6, P < 0.001), concerns about long-term medication use (17.2 vs. 13.9, P < 0.001), and worries medications are overused (9.0 vs. 7.6, P < 0.002). Specific beliefs, including "medications are toxic" and concerns about dependency, were significantly more prevalent in BIPOC/H respondents (P < 0.05).

BIPOC/H patients with IBD had more delays in diagnosis, medication-related concerns, IBD-related financial difficulties, and less social/emotional support for their IBD versus W/NHs, underscoring the need for culturally sensitive care, identification and communication of emotional, and community support resources, as well as medication decision support.