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Dohos D, Váradi A, Farkas N, Erős A, Párniczky A, Schäfer E, Kosaras É, Czelecz J, Hegyi P, Sarlós P. Hungarian Linguistic, Cross-Cultural, and Age Adaptation of the Patient Satisfaction with Health Care in Inflammatory Bowel Disease Questionnaire (CACHE) and the Medication Adherence Report Scale (MARS). Children 2022; 9:1143. [PMID: 36010034 PMCID: PMC9406584 DOI: 10.3390/children9081143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 12/02/2022]
Abstract
Background: The TRANS-IBD study examines the superiority of joint transition visits, with drug adherence and patient satisfaction among the outcome measures. Our aim was a cross-cultural, age- and disease-specific adaptation of the ‘Medication Adherence Rating Scale’ (MARS) and ‘Patient satisfaction with health care in inflammatory bowel disease questionnaire’ (CACHE) questionnaires in patients with inflammatory bowel disease (IBD). Methods: Linguistic and cultural adaptation using test and re-test procedures were performed. Internal consistency with Cronbach’s α coefficients, confirmatory factor analyses with root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI) were determined. Results: A total of 122 adolescents and 164 adults completed the questionnaires (47.5% male, mean age 17 ± 1; and 29.3% male, mean age 38 ± 11, respectively). In the MARS questionnaire, Cronbach’s α scores were found good in adolescents (0.864) and acceptable in adults (0.790), while in the CACHE questionnaire, scores were rated as excellent in both populations (0.906 and 0.945, respectively). The test-retest reliabilities were satisfactory in both groups (MARS questionnaire: r = 0.814 and r = 0.780, CACHE questionnaire: r = 0.892 and r = 0.898, respectively). RMSEA showed poor fit values in the MARS questionnaire and reasonable fit values in the CAHCE questionnaire, CFI and TLI had statistically acceptable results. Conclusion: Age-and disease-specific Hungarian versions of the questionnaires were developed, which are appropriate tools for TRANS-IBD RCT and daily IBD care.
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Vutcovici M, Sewitch M, Kachan N, Stone M, Morin I, Bouchard S, Heatherington J, Devitt KS, Nguyen GC, Bitton A. Patient Perspectives of IBD Care and Services: An Integral Part of a Pan-Canadian Quality Improvement Initiative. J Can Assoc Gastroenterol 2021; 4:229-233. [PMID: 34738068 PMCID: PMC8561267 DOI: 10.1093/jcag/gwaa044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background As beneficiaries of health service improvement initiatives, patients should have their perspectives of and gaps in care elicited to inform and guide the development of quality indicators to assess health care services. The purpose of this study was to identify patient perspectives amenable for conversion into measurable inflammatory bowel disease (IBD) care quality indicators. Methods Crohn’s and Colitis Canada’s Promoting Access and Care through Centres of Excellence (PACE) program organized four patient focus groups in three Canadian provinces in 2016 to capture the perspective of patients on IBD care services. The RQDA package in R was used for transcript analysis, theme identification and for building a theme hierarchy based on the number of citations. The main themes were converted into patient-derived quality indicators. Results Several perceived unmet needs were elicited from participants that could be converted into measurable quality indicators. These unmet needs addressed the need for information, access to multidisciplinary services and specialized care, and access to psychological support. Patient unmet needs informed the selection of nine quality indicators that were included in the final list of PACE indicators to assess IBD care services across Canada. Conclusions Our study provides a detailed description of patient perspectives on IBD care services that were an integral part of the development of measurable indicators of the quality of care in the context of a universal health care system.
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Affiliation(s)
- Maria Vutcovici
- Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada
| | - Maida Sewitch
- Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.,McGill University, Montreal, Canada
| | | | - Marlene Stone
- Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada
| | - Isabelle Morin
- Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada
| | | | | | - Katharine S Devitt
- Department of Research and Patient Programs, Crohn's and Colitis Canada, Toronto, Canada
| | | | - Alain Bitton
- Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada
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Yan X, Qiao Y, Tong J, Mao R, Liang J, Lv C, Chen Y, Wang Y, Shen J. Assessment of patient-centered outcomes (PROs) in inflammatory bowel disease (IBD): a multicenter survey preceding a cross-disciplinary (functional) consensus. Health Qual Life Outcomes 2020; 18:241. [PMID: 32690091 PMCID: PMC7372780 DOI: 10.1186/s12955-020-01489-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 07/10/2020] [Indexed: 02/08/2023] Open
Abstract
Background With a shift in the healthcare paradigm towards a more patient-centered approach, data on inflammatory bowel disease (IBD) needs to be further explored. This study aimed to determine patient perspectives on the effect of IBD and features of patients with lower satisfaction level and compare patient and physician perception of IBD-related Quality of Care (QoC). Methods A previously developed pre-standardised set of questions regarding patient-centered outcome (PRO) measures for IBD, comprising 36 items, was administered in five centers, and a concomitant questionnaire for specialised physicians was adapted and administered. Results Overall, 1005 patients with IBD met the inclusion criteria. Sixty-five questionnaires were administered to specialised physicians. Both patients and physicians perceived the IBD-related QoC as being satisfactory. Furthermore, this study revealed areas of shortcomings where it comes to patient perceptions. Female sex and the presence of negatively impacting disease characteristics (presence of significant pain or discomfort, lack of energy, feeling fatigued most of the time, experiencing anxiety or depression in the last 2 weeks) were associated with lower satisfaction levels. Conclusions Our findings can be used in establishing strategies aimed at improving patient QoC and defining strategic priorities. These data can aid in improving the communication of the pressing needs of IBD patients, to both the public payers and health authorities.
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Affiliation(s)
- Xiaohan Yan
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center; Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China.,Endoscopy Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Yuqi Qiao
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center; Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China
| | - Jinglu Tong
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center; Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China
| | - Ren Mao
- Department of Gastroenterology, the First Affiliated Hospital, Sun Yat-sen University, No.58, Zhong Shan Er Lu, Guangzhou, 510080, China
| | - Jie Liang
- Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Chang Le Xi Lu, Xi'an, 710032, China
| | - Cuicui Lv
- Department of Gastroenterology, the Third Hospital, Liao Cheng, China
| | - Yueying Chen
- Department of Gastroenterology, Zhong Shan Hospital, the Xiamen University, Xiamen, China
| | - Yiyan Wang
- Department of statistics, University of Leeds, Leeds, England
| | - Jun Shen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center; Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, 160# Pu Jian Ave, Shanghai, 200127, China.
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Prasad SS, Potter M, Keely S, Talley NJ, Walker MM, Kairuz T. Roles of healthcare professionals in the management of chronic gastrointestinal diseases with a focus on primary care: A systematic review. JGH Open 2019; 4:221-229. [PMID: 32280768 PMCID: PMC7144774 DOI: 10.1002/jgh3.12235] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/18/2019] [Accepted: 06/30/2019] [Indexed: 02/06/2023]
Abstract
Background and aim Inflammatory bowel disease (IBD) refers to a group of complex and chronic conditions that requires long‐term care delivered by a group of healthcare professionals through a multidisciplinary care model. We conducted a systematic review to examine and understand the role of healthcare professionals in the primary care management of IBD, and identify the gaps in IBD management that could be filled by primary care providers such as general practitioners (GPs) and pharmacists. Methods The search strategy retrieved published studies from five databases, and eligible articles were assessed for quality. A gray literature search of the websites of organizations was also undertaken. Results Twenty‐one studies were included, of which 19 were peer‐reviewed research articles and two reports were from organizational bodies. Although studies have shown the roles of GPs, pharmacists, dietitians, and psychologists in IBD management, nurses and gastroenterologists were the key drivers delivering specialized care to IBD patients. Many key services are accessible only for hospital inpatients (tertiary care) or through outpatient clinics (secondary care) with an absence of a multidisciplinary approach including GPs and pharmacists. Conclusion Gastroenterologists and nurses have an important role in the delivery of care to patients with chronic gastrointestinal diseases including IBD, coeliac disease, irritable bowel syndrome, and functional dyspepsia. The role of nurses includes provision of specialized care to IBD patients, as well as supportive care such as education, monitoring of therapy, and ongoing assistance. The available evidence shows many opportunities for primary care providers to play a more active role in the management of IBD patients.
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Affiliation(s)
- Sharmila S Prasad
- Faculty of Health and Medicine, School of Biomedical Science and Pharmacy University of Newcastle Callaghan New South Wales Australia.,Priority Research Centre, Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights New South Wales Australia
| | - Michael Potter
- Priority Research Centre, Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights New South Wales Australia.,Faculty of Health and Medicine, School of Medicine and Public Health University of Newcastle New Lambton Heights New South Wales Australia
| | - Simon Keely
- Faculty of Health and Medicine, School of Biomedical Science and Pharmacy University of Newcastle Callaghan New South Wales Australia.,Priority Research Centre, Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights New South Wales Australia
| | - Nicholas J Talley
- Priority Research Centre, Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights New South Wales Australia.,Faculty of Health and Medicine, School of Medicine and Public Health University of Newcastle New Lambton Heights New South Wales Australia
| | - Marjorie M Walker
- Priority Research Centre, Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights New South Wales Australia.,Faculty of Health and Medicine, School of Medicine and Public Health University of Newcastle New Lambton Heights New South Wales Australia
| | - Therése Kairuz
- Faculty of Health and Medicine, School of Biomedical Science and Pharmacy University of Newcastle Callaghan New South Wales Australia
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5
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Pittet V, Vaucher C, Froehlich F, Maillard MH, Michetti P. Patient-reported healthcare expectations in inflammatory bowel diseases. PLoS One 2018; 13:e0197351. [PMID: 29772017 PMCID: PMC5957384 DOI: 10.1371/journal.pone.0197351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 05/01/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Patient-reported experience is an important component of a holistic approach to quality of care. Patients' expectations of treatments and global disease management may indicate their illness representations and their satisfaction and hopes regarding quality of care. OBJECTIVE To study expectations of patients with inflammatory bowel disease. METHODS Two focus groups were conducted with 14 patients to explore their expectations about treatments and disease management. From qualitative content analyses of focus group discussions, we built a 22-item expectations questionnaire that was sent to 1756 patients of the Swiss IBD cohort. Answers were collected on a visual analog scale from 0 to 100, and medians (interquartile range [IQR]) calculated. Factor analysis identified main expectation dimensions, and multivariate analyses were performed to describe associations with patient characteristics. RESULTS Of 1094 patients (62%) included in the study, 54% were female, 54% had Crohn's disease, 35% had tertiary education, and 72% were employed. Expectation dimensions comprised realistic, predictive, and ideal expectations and were linked to information, communication, daily care, and disease recognition. Half (11 of 22) of the expectations were ranked as very high (median score > 70), the 2 most important being good coordination between general practitioners and specialists (median score: 89, IQR: 71-96) and information on treatment adverse events (89, IQR: 71-96). Women had overall higher levels of expectations than did men. Expectations were not associated with psychosocial measures, except those related to disease recognition, and most of them were highly associated with increased concerns on disease constraints and uncertainty. CONCLUSIONS Patients have high expectations for information and communication among caregivers, the levels varying by gender and region. Patients also appear to request more active participation in their disease management.
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Affiliation(s)
- Valérie Pittet
- Institute of Social & Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
- * E-mail:
| | - Carla Vaucher
- Institute of Social & Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Florian Froehlich
- Division of Gastroenterology & Hepatology, Lausanne University Hospital, Lausanne, Switzerland
- Division of Gastroenterology & Hepatology, Basel University Hospital, Basel, Switzerland
| | - Michel H. Maillard
- Division of Gastroenterology & Hepatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre Michetti
- Crohn and Colitis Center, Gastroentérologie Beaulieu SA, Lausanne, Switzerland
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Guarini A, Biagini S, Capaldi A, Carretto D, Angelis AD, Iudice S, Martino G, Marziali B, Mattiola R, Ongarelli C, Onidi FM, Prinzio M, Puthiavettil R, Sardi R, Schiavoni E, Sinatora R, Zullo A. Satisfaction and expectations of patients with inflammatory bowel disease on biologic therapy: a multicenter study. Ann Gastroenterol 2017; 30:96-100. [PMID: 28042244 PMCID: PMC5198254 DOI: 10.20524/aog.2016.0100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/04/2016] [Indexed: 12/12/2022] Open
Abstract
Background The satisfaction perceived by patients with chronic diseases affects clinical outcomes and healthcare costs. Some patients with inflammatory bowel disease (IBD) develop a more severe form requiring biologic therapy. We assessed the quality of care perceived by IBD patients in dedicated centers. Methods This prospective, cross-sectional, multicenter study enrolled consecutive IBD patients who underwent biologic therapy in the participating centers. The nurses directly involved in the management of these patients explained the rationale of the survey, provided a specific questionnaire (CACHE), and collected data. The CACHE included 31 items structured in 6 domains: staff care, clinician care, center facilities, patient information, accessibility, and patient support. Patients’ satisfaction score for each domain ranged from 0 to 100%. Results Sixteen different Italian centers participated and a total of 450 patients were enrolled (283 with Crohn’s disease and 167 with ulcerative colitis). The overall score was 82.2±19.6, satisfaction with the clinicians care scoring the highest (87.6±3.2) and the information provided to the patient scoring the lowest (70.7±7.9). More specifically, it emerged that 5.2-19.5% of patients were unsatisfied with: 1) the communication between the IBD medical team and primary care physicians; 2) information received about the disease or patients’ associations; and 3) the accessibility of the center. Conclusion Although our data revealed an acceptably high rate of global satisfaction among IBD patients receiving biologic therapy, more effort should be made to improve patient information and communication between IBD teams, other specialists and primary care physicians.
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Affiliation(s)
- Alessandra Guarini
- Department of Gastroenterology Nuovo Regina Margherita Hospital, Rome (Alessandra Guarini, Angelo Zullo)
| | - Silvia Biagini
- Department of Gastroenterology Careggi Hospital, Florence (Silvia Biagini)
| | - Antonella Capaldi
- Department of Gastroenterology Santa Scolastica Hospital, Cassino (Antonella Capaldi)
| | - Daniela Carretto
- Department of Gastroenterology Cardinal Massaia Hospital, Asti (Daniela Carretto)
| | - Anna De Angelis
- Department of Gastroenterology Fabrizio Spaziani Hospital, Frosinone (Anna De Angelis)
| | - Salvatore Iudice
- Department of Gastroenterology INRCA U. Sestilli Hospital, Ancona (Salvatore Iudice)
| | - Giuseppina Martino
- Department of Gastroenterology IRCSS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Giuseppina Martino)
| | - Barbara Marziali
- Department of Gastroenterology A. Murri Hospital, Fermo (Barbara Marziali)
| | - Roberta Mattiola
- Department of Gastroenterology Maria Vittoria Hospital, Turin (Roberta Mattiola)
| | - Cristina Ongarelli
- Department of Gastroenterology Sant' Andrea Hospital, La Spezia (Cristina Ongarelli)
| | | | - Manuela Prinzio
- Department of Gastroenterology Mauriziano Hospital, Turin (Manuela Prinzio)
| | - Reetha Puthiavettil
- Department of Gastroenterology Tor Vergata University Hospital, Rome (Reetha Puthiavettil)
| | - Romina Sardi
- Department of Gastroenterology San Camillo Hospital, Rome (Romina Sardi)
| | - Elisa Schiavoni
- Department of Gastroenterology Gemelli University Hospital, Rome (Elisa Schiavoni)
| | - Rita Sinatora
- Department of Gastroenterology Pugliese Ciaccio Hospital, Catanzaro (Rita Sinatora), Italy
| | - Angelo Zullo
- Department of Gastroenterology Nuovo Regina Margherita Hospital, Rome (Alessandra Guarini, Angelo Zullo)
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Jelsness-Jørgensen LP, Bernklev T, Hovde Ø, Prytz Berset I, Huppertz-Hauss G, Moum B, Lie Høivik M. Patients' perceptions of quality of care and follow-up in inflammatory bowel disease. Scand J Gastroenterol 2016; 51:434-41. [PMID: 26635189 DOI: 10.3109/00365521.2015.1102319] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Quality of care (QoC) has gained increased attention in IBD. A better QoC has, historically, been linked to improved treatment outcomes. Even so, factors of equal importance to patients may be quality of life (QoL), patient-physician communication and access to care. Recent surveys suggest that IBD care in Europe is suboptimal. METHODS Patients were recruited from nine hospitals in the south-eastern and western part of Norway as a part of an observational, multicenter study In addition to clinical and socio-demographic factors; a purposely designed 26 item questionnaire was used to quantify aspects related to IBD care, including QoC. Moreover, the Fatigue Questionnaire (FQ) was used to investigate fatigue. RESULTS In total, 411 patients were included. Of these, 231 were diagnosed with CD and 180 with UC. Furthermore, 86.1% (354/411) were satisfied with the quality of IBD follow-up and only 4.1% (17/411) were dissatisfied. Most dissatisfaction was related to: lack of focus on personal relations (18.2%), HRQoL (15.1%), general practitioner knowledge of IBD (13.9%), ability to talk about important topics (7.8%), and hospital discharge communication (9.4%). Higher age and longer disease duration was associated with improved QoC scores in both UC and CD. Fatigue was associated with decreased QoC scores in both diagnoses. CONCLUSIONS Patients are satisfied with quality of care in IBD. However, communication seems to be an important area of improvement - not only related to patient-physician communication, but also to transitional communication between different health-care levels.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- a Østfold University College, Health Science , Halden , Norway ;,b Department of Gastroenterology, Østfold University College, Health Science/Østfold Hospital Trust , Fredrikstad , Norway
| | - Tomm Bernklev
- c Department of Research , Telemark Hospital Trust , Skien , Norway
| | - Øistein Hovde
- d Institute of Clinical Medicine, University of Oslo , Nydalen , Oslo , Norway ;,e Department of Gastroenterology , Innlandet Hospital Trust , Gjøvik , Norway
| | - Ingrid Prytz Berset
- f Department of Gastroenterology , Møre and Romsdal Hospital Trust Ålesund , Ålesund , Norway
| | | | - Bjørn Moum
- h Department of Gastroenterology/University of Oslo , Oslo University Hospital, Institute of Clinical Medicine , Nydalen , Oslo , Norway
| | - Marte Lie Høivik
- i Department of Gastroenterology , Oslo University Hospital , Nydalen , Oslo , Norway
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8
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Casellas F, Ginard D, Riestra S. Patient satisfaction in the management of mild-to-moderate ulcerative colitis: Results of a Delphi study among patients and physicians. Dig Liver Dis 2016; 48:1172-9. [PMID: 27474198 DOI: 10.1016/j.dld.2016.06.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/11/2022]
Abstract
GOALS To determine factors contributing to satisfaction with treatment in mild-to-moderate ulcerative colitis (UC) from both the patients and the physicians perspectives. BACKGROUND Despite the impact of UC on different aspects of daily life, patient's and physician's satisfaction with clinical management has been poorly evaluated. STUDY A Delphi study involving 22 patients and 20 clinicians was conducted. The patient's questionnaire included 285 items regarding diagnosis, treatment, and follow-up, whereas the physician's questionnaire added 32 specific items for clinicians. Relevance of items was scored from 1 (not at all important) to 9 (very important). Recommendations were based on very highly rated items. RESULTS Most items were rated consistently by patients and physicians with some exceptions. Patients emphasized the choice of moderate flare-ups to be followed at the hospital setting rather than in primary care as well as to be informed on aspects, such as diet and impact of UC on their health and lifestyle. Treatment-related efficacy, safety, and improved quality of life were relevant for both patients and physicians. Physicians believed that to reduce pill burden was a crucial aspect to improve patient's satisfaction. Patients preferred oral administration treatment over rectal treatment. CONCLUSIONS The study identified specific aspects related to the management of mild-to-moderate UC that both patients and physicians considered to be highly relevant for patient satisfaction. Recommendation based on these factors would be important at the time of designing and implementing strategies targeting satisfaction in UC patients.
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Affiliation(s)
- Francesc Casellas
- Crohn-Colitis Care Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Daniel Ginard
- Gastroenterology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
| | - Sabino Riestra
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
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Barreiro-de Acosta M, Argüelles-Arias F, Hinojosa J, Júdez Gutiérrez FJ, Tenías Burillo JM. How is inflammatory bowel disease managed in Spanish gastroenterology departments? The results of the GESTIONA-EII survey. Rev Esp Enferm Dig 2016; 108:618-626. [PMID: 27651018 DOI: 10.17235/reed.2016.4410/2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
INTRODUCTION Not all national health centers include specialized units or clinicians devoted to inflammatory bowel disease. The goal of the survey was to gain an insight into the management of this disease within Spanish gastroenterology departments via a survey among their members. MATERIAL AND METHODS An online survey was conducted in February and March 2015, among SEPD members (2017 clinician members), who were split into three categories: heads of department, general gastroenterologists, and experts in this disease. The results of the last two surveys are reported, including demography-related questions and specific questions on the strategies and resources available for the care of these patients. RESULTS A total of 166 responses were received (response rate 8.19%), excluding those from heads of department (previously published). Sixty gastroenterologists considered themselves experts in inflammatory bowel disease, and 106 non-experts in it, the latter being either general gastroenterologists or specialists in other areas, mainly endoscopy. Twenty-eight percent of non-expert gastroenterologists said their hospitals had specific units, with a monographic clinic in 46%. However, 26% reported that they were treating affected patients themselves. Experts in inflammatory bowel disease reported that their institute had resources to support their work, but there was a lack of surgeons with expertise in this condition, particularly in county hospitals. CONCLUSIONS At least, within SEPD members, 2 out of 3 experts in inflammatory bowel disease seem to have the resources available for their work (nurses, day unit, telephone line, database, referrals, joint sessions). Although there is room for improvement (email to contact patients, devoted surgeon, absence of referral protocols), and 2 out of 3 are concerned about pharmacy costs. Since a substantial number of patients remain treated by general practitioners, rapid referral programs might be helpful in this setting.
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Amo L, González-Lama Y, Suárez C, Blázquez I, Matallana V, Calvo M, de la Revilla J, Vera MI, Abreu L. [Impact of the incorporation of a nurse in an inflammatory bowel disease unit]. Gastroenterol Hepatol 2016; 39:318-23. [PMID: 26826777 DOI: 10.1016/j.gastrohep.2015.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/09/2015] [Accepted: 09/09/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Multidisciplinary units are needed because of the growing complexity and volume of patients with inflammatory bowel disease (IBD). OBJECTIVES To evaluate the healthcare, economic and research impact of incorporating a nurse into the IBD unit of the Puerta de Hierro Majadahonda University Hospital. METHODS We prospectively recorded the activity carried out by the nurse of the IBD unit from March 2010 to December 2014. RESULTS During this period, healthcare demand progressively increased, with 1,558 patients being attended by our unit. The healthcare provided by the nurse included 5,293 electronic mails and 678 telephone calls. We estimated that this activity represented a saving of 3,504 in-person medical consultations and 852 accident and emergency department visits. Other activities consisted of monitoring treatments with biological and non-biological agents (8,371 laboratory tests), extraction of 342 blood samples, follow-up of 1047 diagnostic tests and consultations with other medical specialties, health education in self-administration of drugs in 114 patients, the performance of 158 granulocyte apheresis procedures, and participation in 25 research projects. CONCLUSION The incorporation of a specialised nurse in an IBD unit had major economic, healthcare and research benefits.
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Faus AL, Turchi RM, Polansky M, Berez A, Leibowitz KL. Health-Related Quality of Life in Overweight/Obese Children Compared With Children With Inflammatory Bowel Disease. Clin Pediatr (Phila) 2015; 54:775-82. [PMID: 25520367 DOI: 10.1177/0009922814562555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE This study examined the health-related quality of life (HRQOL) of pediatric patients with overweight/obesity compared with that of patients with inflammatory bowel disease. METHODS Differences between disease groups in their PedsQL 4.0 HRQOL survey scores were analyzed using unpaired t tests and analyses of variance. RESULTS Scores of patients with overweight/obesity were as low as scores of patients with inflammatory bowel disease. Parent/guardian-proxy social functioning scores of the overweight/obese group were statistically significantly lower than scores of the inflammatory bowel disease group, and the parents/guardians reported significantly lower HRQOL scores than the patients. CONCLUSIONS Overweight/obese children have HRQOL scores as impaired as those of children with inflammatory bowel disease. According to proxy-reported scores, overweight/obesity is associated with lower social functioning. Thus, it is important for health care providers to recognize obesity's relationship to patients' psychosocial health and provide holistic care that addresses the severity of this disease.
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Affiliation(s)
- Amy L Faus
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA Drexel University School of Public Health, Philadelphia, PA, USA
| | - Renee M Turchi
- Drexel University School of Public Health, Philadelphia, PA, USA
| | - Marcia Polansky
- Drexel University School of Public Health, Philadelphia, PA, USA
| | - Andrea Berez
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Lucendo AJ, Hervías D, Roncero Ó, Lorente R, Bouhmidi A, Angueira T, Verdejo C, Salueña I, González-Castillo S, Arias Á. Epidemiology and temporal trends (2000-2012) of inflammatory bowel disease in adult patients in a central region of Spain. Eur J Gastroenterol Hepatol 2014; 26:1399-407. [PMID: 25341061 DOI: 10.1097/MEG.0000000000000226] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM A growing incidence of inflammatory bowel disease (IBD) has been reported recently in southern Europe, with records of pediatric cases confirming these tendencies in Spain. Data on adult populations, however, have not been provided for over 10 years and need to be updated. PATIENTS AND METHODS A multicenter retrospective registry of all adult patients with a diagnosis of IBD, including both Crohn's disease (CD) and ulcerative colitis (UC), attending five public hospitals covering a population of 514 368 inhabitants, was assessed. RESULTS In 2012, the prevalence of CD and UC in adults was 137.17/100 000 inhabitants (95% confidence interval 114-160) and 99.84/100 000 inhabitants (95% confidence interval 79-119), respectively. The mean incidence rate during the period 2000-2012 of CD and UC was 8.9 and 5.6/100 000 inhabitants per year, respectively. Most of our patients (75.55%) had been diagnosed during the last 13 years. CD affected both sexes equally; a trend toward a progressive increase in the age at diagnosis, ileal location, and inflammatory behavior was documented for CD patients. In contrast, UC affected male patients with a higher frequency (57.8%; P=0.015), specifically those older than 40 years of age. Age at UC onset tended to increase progressively from 2000 to 2012 (P<0.001), but the extension on the disease remained unchanged. CONCLUSION IBD is a highly prevalent disorder in our region, reaching the incidence of CD similar to the figures provided for Northern Europe. Changes in IBD localization, behavior, and age at diagnosis were documented during the period 2000-2012.
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