S620 Assessing the Concordance Between Patients With Eosinophilic Esophagitis and Their Treating Physicians: Evidence From a Real-World Study

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Introduction: Eosinophilic esophagitis (EoE) is a chronic disease characterized by esophageal dysfunction and eosinophilic inflammation. A shared understanding of patients’ perceptions and values, along with a comprehensive awareness of the probable prognosis and potential treatment outcomes, is crucial for physicians and patients. Prior research suggests patients prioritize symptom and quality of life (QoL) improvement as treatment outcomes; aligning patient and physician treatment goals can enhance outcomes. We explored patient-physician concordance in EoE treatment. Methods: Data were drawn from the Adelphi EoE Disease Specific Programme (DSP), a real-world, cross-sectional survey with retrospective data collection of physicians and their patients with EoE in EU (France, Germany, Italy, Spain), UK, and US from Jul–Dec 2023. Physicians abstracted clinical data reporting demographics, symptoms, and reasons for choice of treatment for consecutively consulting patients with EoE, and patients reporting their treatment perspectives. Descriptive analyses were performed. Results: Overall, 190 physicians reported data for 1141 patients, of whom 285 completed a survey. Most patients were male (65%) and White (95%), with a mean (SD) age of 35.8 (12.3) y and mean (SD) duration of current treatment of 1.80 (2.03) y. Prior to diagnosis, the most common symptoms reported were dysphagia (physician: 84% vs patients: 80%), heartburn (60% vs 80%), and food impaction (56% vs 54%); discrepancies were seen in current symptoms: dysphagia (33% vs 43%) and heartburn (36% vs 43%) (Table 1). Physicians reported symptomatic relief (84%), improvements in QoL (64%), and speed of onset (48%) as the most common reasons for selecting current treatment. Patients reported reduction in symptoms (75%), ease of administration (42%), and lack of side effects (40%) as the most common perspectives on treatment (Figure 1). Patients (86% vs 79% of physicians) reported needing additional support such as help with personal care, daily activities, taking medications, or emotional support. Conclusion: Although patient and physician perceptions on reported disease symptoms prior to diagnosis were generally aligned, they were less so on current symptoms. Differences were also seen in physicians’ priorities for choice of treatment and patients’ perspectives on treatment. Further, physicians may underestimate symptom burden and overestimate treatment impact on QoL, leading to unmet needs.Figure 1.: Physician-reported reasons for choice of treatment (n=240) and patient-reported perspectives on treatment (n=240). Note: not all questions were answered by the physicians and patients. Table 1. - Physician- and Patient-reported EoE Symptoms Symptoms present before diagnosis Current symptoms Patient form Physician form Patient form Physician form Symptoms 279 279 251 251 Difficulty swallowing/dysphagia 223 (80%) 233 (84%) 109 (43%) 83 (33%) Heartburn/acid reflux 153 (55%) 168 (60%) 108 (43%) 90 (36%) Regurgitation (spitting up) 101 (36%) 94 (34%) 48 (19%) 33 (13%) Choking on food 110 (39%) 89 (32%) 40 (16%) 18 (7%) Pain with swallowing/odynophagia 134 (48%) 101 (36%) 44 (18%) 22 (9%) Nausea 61 (22%) 72 (26%) 39 (16%) 32 (13%) Stomach pain 56 (20%) 61 (22%) 23 (9%) 13 (5%) Lack of appetite/food refusal/poor appetite 26 (9%) 33 (12%) 21 (8%) 8 (3%) Food stuck in your throat/food impaction 152 (54%) 155 (56%) 42 (17%) 30 (12%) Vomiting 51 (18%) 57 (20%) 8 (3%) 8 (3%) Chest pain 78 (28%) 90 (32%) 17 (7%) 17 (7%)

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