Determinants of Topical 5-Aminosalicylic Acid Use inVeterans with Ulcerative Colitis

Aims: The aim of our study was to identify the determinants of topical 5-ASA therapy in a large ulcerative colitis cohort. Methods: We performed a cross sectional study of patients receiving care through the Veterans Administration (VA) from 2003 to 2009. Patients with UC were identified using ICD-9 codes. Patient demographic and prescription data were obtained from national VA datasets. Univariate and multivariate logistic regression were used to identify the effect of age, gender and race on topical 5-ASA therapy use. Results: We identified 20,259 UC patients for inclusion in the analysis. The prevalence of topical 5-ASA therapy use was 27%. With univariate logistic regression, female gender and non-Caucasian race were associated with a higher odds of topical 5-ASA therapy use. Increasing age was associated with lower odds of topical 5-ASA therapy use. On multivariate logistic regression, Blacks and Hispanics remained more likely to use topical 5-ASA therapies compared to Caucasians and increasing age remained associated with a lower odds of topical 5-ASA therapy; however, other demographic features lost significance. Conclusions: In a large, national cohort of patients with UC, Blacks and Hispanics were more likely to use topical 5-ASA therapies compared to patients of other ethnicities.