P224 Crohn’s disease experiences among a paediatric population: A qualitative study reviewing the agreement of symptoms discussed by children and adolescents

Abstract

Background Crohn’s disease (CD) is a type of inflammatory bowel disease that can occur at any age. CD symptoms can have a significant impact on health-related quality of life (HRQL). Although key symptoms and impacts of CD in adults are well-known, they have not been well explored or documented in children and adolescents. The objective of this study was to explore the similarities and differences in CD symptoms and impacts across various age groups (children and adolescents) and develop a list of most common symptoms and impacts for these populations. Methods Children (ages 5–11 years) and adolescents (ages 12–17 years) with CD and parents/caregivers of children with CD (ages 2–11 years) were recruited from US medical practices. Qualitative semi-structured interview guides were developed, informed by published literature. Face-to-face and telephone concept elicitation interviews were conducted, audio-recorded, and transcribed. Transcripts were analysed using thematic methods facilitated by NVivo. Results A total of 49 individuals participated in this study (child n = 11, adolescents n = 20, parents/caregivers n = 18). Preliminary results showed that there was a high level of qualitative agreement between CD symptoms in children and adolescents. The ranking of the top 15 symptoms was nearly identical between the two cohorts. The most frequently discussed symptoms (discussed by ≥75% of the participants in each cohort) were feeling gassy, abdominal pain, diarrhoea, incomplete evacuation, tiredness, and urgency. The second most frequently discussed symptoms (discussed by ≥50% of the participants in each cohort) were cramping, constipation, blood in stool, and frequent bowel movement. While abdominal cramping and blood in stool were discussed by ≥75% of the adolescents, 63% and 50% of the children discussed them respectively. Similarly, while bloating and nausea were discussed by ≥50% of adolescents, 38% and 25% of children discussed them, respectively. Finally, while vomiting was discussed by 50% of the children, 33% of the adolescents discussed it. Impacts due to CD were also regularly discussed across both cohorts but less so by the children. School and low mood/sadness were discussed by ≥50% of the participants in each cohort. Exercise/sport, play/leisure activities, annoyance/frustration, and eating/drinking limitations were discussed by ≥50% of the adolescents but <50% of the children. Conclusion The results from the CE interviews show the clear burden of CD and that this is mostly similar across children and adolescents allowing for a future unified disease model to be developed.