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Characteristics Associated With Probiotic Use Among Patients Experiencing Constipation-Related Symptoms: Results From the CONTOR Study: 2245

AMERICAN JOURNAL OF GASTROENTEROLOGY(2015)

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Abstract
Introduction: Among patients with irritable bowel syndrome with constipation (IBS-C) and chronic constipation (CC), treatment often includes over-the-counter products, such as probiotics. This analysis describes characteristics of CONTOR respondents who did and did not report probiotic use. Methods: Fully-insured patients aged ≥18 years were identified from a large, geographically-diverse US health plan from December 2012 to April 2014. Identification criteria included ≥1 medical claim with an ICD-9 diagnosis code for constipation (564.0x), IBS (564.1x) or abdominal pain (789.0x), plus ≥1 pharmacy claim for a stool softener/laxative; or ≥1 pharmacy claim for linaclotide or lubiprostone. Patients were invited by mail to participate in the study and complete a self-administered paper survey assessing symptoms, treatment, and quality of life. Respondents were included in the probiotic user analytic group if they reported probiotic use in the past 6 months.Table 1: Characteristics of Probiotic Use among CONTOR respondentsResults: Among the 9,590 patients who met the inclusion criteria and were invited to participate in the CONTOR study, 1,136 eligible patients responded and are included in this analysis. Most respondents were female (94%); mean age (SD) was 47(12) years. Overall, 610 (54%) reported probiotic use in the past 6 months; of these, 61% reported use in the past 7 days. Demographic characteristics of probiotic users were not significantly different from non-users (n=526) with the exception of race, where probiotic users were less likely to be black (p=0.004) and more likely to be Asian (p=0.017). Probiotic users were more likely to report a health care provider diagnosis of IBS-C (p < 0.001), and to report symptoms consistent with modified Rome III IBS-C criteria (p=0.002). Probiotic users reported more severe abdominal symptoms (PAC-SYM) and lower symptom-related quality of life overall and on 3 of the 4 subscales of the PAC-QOL (Table). Conclusion: Compared to non-users, probiotic users were more likely to have a diagnosis of IBS-C, severe abdominal symptoms, and lower quality of life than other respondents in the CONTOR study. Over half of study respondents reported probiotic use, highlighting the widespread use of probiotics by patients with gastrointestinal symptoms, especially IBS-C, despite inconclusive evidence on the benefit of probiotics in treating these conditions. It is unknown, based on these data, whether probiotics are used more commonly because of more severe IBS-C symptoms or if probiotics may be causing more severe symptoms.
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Key words
probiotic use,constipation-related
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