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Background Patient adherence to his/her medication is a major challenge in the successful management of any chronic disease and it is a major challenge in Ulcerative Colitis (UC). Patient adherence is thought to be closely related to patient preference of medication and formulation used. We wanted to investigate the patient preference between tablets and granules of mesalazine and compare it to the physician perception. Methods We conducted an online survey between November and December 2020 in 4 EU countries (France, Germany, Spain, and the UK). In addition to patients and physicians from these 4 countries, the questionnaire was also addressed to IBD nurses from the UK. Patients were included if they had mild or moderate UC. Results 400 patients, 160 physicians, 20 nurses participated in this survey. 68% patients were taking tablets and 32% granules. 62% of the patients who answered the survey admitted their preference for tablet while only 38% for granules (figure 1). 63.9% of the physician would prefer to prescribe tablets for their patients. Physicians stated that patients tend to be more adherent to tablets than granules (69% vs. 31%) and patients tend to find this the most convenient formulation. When patients were asked about some positive attributes of tablets, the highest agreement was with “good size, easy to see and handle” (7.6/10) while for granules “no problem to take granules in public” (8.4/10). When asked about some negative attributes of tablets, the highest agreement was with “I would like to take fewer each day” (6.1/10) and “I wish I could take fewer at a time” (5.4/10) while for granules “you have to drink a lot of liquid for them to go down” (6.6/10) and “I wish I could take fewer” (5.1/10). 50 patients were switched to tablets after trying granules first and 45 to granules after trying tablets. Treatment changes were initiated mainly by the physician (57% of the time). Patients switching to granules almost all agreed that they wanted to take fewer tablets each day (8.1/10). Patients switching to tablets complained about the need to drink a lot of water with granules (6.5/10) or to mix them with food (6.3/10). This is also reflected in the way patients take tablets (figure 2) or granules (figure 3). While 71% of the patients swallow the tablets whole only 35% of the patients swallow all the granules at once. 37% mix the granules with food or liquid, 20% divide the portions to be able to swallow them and 8% chew the granules. Asked about adherence, only 21% (85 patients) admitted taking less than 80% of prescribed medication. Conclusion The majority of the patients prefer the tablet formulation. A high strength tablet overcoming the pill burden could be a good solution to address patient expectations.

P558 Medication Preference of 400 patients with mild to moderate Ulcerative Colitis