PGI12 Healthcare Resource Utilization Associated with Complex Perianal Fistula in Crohn's Disease in FIVE European Countries: The Preface Study, a Retrospective Chart Review

There is limited information on healthcare resource utilization (HCRU) regarding complex perianal fistula (CPF) in Crohn’s disease (CD) in a multi-country setting. This study describes direct medical HCRU in patients with CD and CPF in five European countries. We conducted a retrospective medical chart review of patients with CD receiving treatment for a new episode of CPF from September 2011 to September 2014, in Belgium, France, Germany, Italy and Spain. Index date was defined as date of CPF-treatment initiation. Data on healthcare resources were collected for the follow-up period from index date for at least 3 years (except for deceased or lost to follow-up patients). In total, 372 patients (49% female) with mean (SD) age of 38 (13) years were included in the study by 19 gastroenterologists and 12 surgeons. Time since CD diagnosis was on average 10 (9) years, and length of follow-up 6 (1) years. For 95% of patients at least one visit to gastroenterologists and for 70% of patients at least one visit to a surgeon was documented in the follow-up period. One fifth had a requested visit (22%) or a visit due to systemic treatment administration (19%) beside scheduled follow-up visits. For most patients in Belgium (52%) and Spain (57%) an emergency room visit, and for most patients in Belgium (67%), Spain (57%) and Germany (54%) a hospitalization in wards other than ICU was reported. For more than 90% of patients liver function test, MRI, and total coloscopy/ileocoloscopy were performed with similar rates in most countries. Rates of emergency room visits and hospitalization are over 50% in some countries. There were no relevant differences regarding assessments or procedures between countries. MRI and total coloscopy/ileocoloscopy were performed in most patients. Further research is warranted to understand specific HCRU drivers in CPF in CD.