P1224Use and expectations on complementary and alternative medicines in inflammatory bowel diseases in Switzerland

Background Complementary and alternative medicines (CAM) may be defined as treatments that fall outside of conventional healthcare. CAM are widely used by IBD patients. Reimbursement of CAM by basic health insurance is changing and limited. Further information is needed on the actual access to CAM approaches in IBD patients, which was the objective of this study. Methods We performed a cross-sectional study on patients included in a national cohort study. We sent patients a questionnaire to collect socio-economic and demographic characteristics of the respondents, as well as type of CAM used, self-reported outcomes and out-of-pocket expenditures. We performed descriptive analysis. Logistic regression was performed to investigate factors associated with recent CAM users. Results 1062 patients answered to the questionnaire, 52.4% females, 55.1% CD, mean (SD, range) age was 51.2 (14.8, 18-88) years and disease duration 18.6 (10.9, 20-63) years. A total of 514 (48.8%) reported having used a CAM at least once since IBD diagnosis, 324 (30.5%) during the last 2 years (2016-2017). Factors associated with last 2 years increased use were sex (OR = 2.16, 95%CI:1.51-3.09) and increased with education levels. Most frequent reasons for non-use were not feeling the need to use CAM (31.1%) never considered taking CAM (25.9%) and no believe CAM can help (24.3%). Detailed list of CAM reported by patients is shown table1, most frequent were acupuncture, probiotics or prebiotics and homeopathy. People who recommend CAM were friends or family (51.3%), GP (11.8%), gastroenterologist (8.3%), media or internet (19.9%) or a naturopath (14.3%). Objectives for using CAM were QoL improvement (74.6%), IBD symptoms relief (56.6%), flare avoidance (44.2%), or lowering of treatment adverse events (8.5%). In 85.8% of cases, the expected objective was deemed to have been achieved. 79.0% reported CAM were not reimbursed by their basic health insurance, 52.9% neither from complementary insurance. Mean out-of-pocket expenditures for CAM was 640 EUR (0-5’420 EUR). Conclusion Use of CAM in IBD is high, mainly used to improve quality of life and help for symptoms. In Switzerland, patients spend a lot of out-of-pocket money for CAM, although they are mostly not reimbursed by health insurances. Conflict of interest: Carrodano, Cinzia: No conflict of interest Dr. Pittet, Valérie: No conflict of interest