Eamonn M. M. Quigley
Patients with constipation predominant irritable bowel syndrome expressed dissatisfaction with the available treatments for their symptoms, despite coping with their condition better than their doctors expected, according to survey results published in Advances in Therapy.
M. M. Quigley, MD, of Houston Methodist Hospital, and colleagues developed and administered the survey for the BURDEN IBS-C study to discover how patients experience IBS-C and to learn if any unmet needs still exist in managing these patients.
“The goal was to look at what was really the impact of IBS-C on the patient and what were the patient perceptions of the disorder, and to see how closely that was married to the perception of the physicians who were caring for them.” Quigley told Healio Gastroenterology and Liver Disease.
In the second half of 2016, Quigley and colleagues surveyed 1,311 patients with IBS-C and 331 health care providers who treat patients with IBS-C. These providers included gastroenterologists, primary care providers, nurse practitioners and physician assistants. The patients included individuals who already had been diagnosed with IBS-C, as well as patients without a previous diagnosis whom researchers identified following a screening questionnaire.
The survey revealed that IBS-C had a negative impact on the patients’ lives by affecting things like their work productivity and social lives. Most of the patients (60%) described their symptoms as “somewhat-to-extremely bothersome.”
“These disorders — which are generally regarded as pretty benign — are actually impacting people’s lives,” Quigley said. “About half of the responders found that their productivity or their personal activity was impacted by IBS-C for at least one day a month. For some of these people, it was much more severe than that. There were people in there who were experiencing a significant impact on their daily life, whether it was going to school, or going to work, being with their family. I think that’s an important factor and maybe one that we’re not taking into account when we manage people.”
Among patients who had taken or were currently on treatments for IBS-C, 37% reported being satisfied or completely satisfied with the available treatments. More responders were taking over-the-counter treatments (76%) than prescription medications for IBS-C (12%). Quigley noted that the survey was completed before a few of the current prescription treatments were made available, but the results show that non-prescription treatments still leave a lot to be desired.
“Over-the-counter treatments aren’t really effective in this population,” he said. “Laxatives relieve constipation, but there really is not much evidence that they relieve the pain and the bloating and the other symptoms that are characteristic of IBS-C.”
Despite the challenges they face in managing IBS-C, the survey showed a portion of the patients (39%) had “accepted” the condition as a part of daily life. The physicians recognized their patients were stressed (65%) or frustrated (76%) by their condition, but only 13% reported they recognized this acceptance in their patients.
“Patients were better at coping with their symptoms than the physicians thought they were,” Quigley said, adding that whether that is because of a lack of time spent with patients or simply a problem of perception remains unclear.
Quigley said physicians need to give a lot of attention to their patients with IBS-C and understand how their condition is affecting their lives, while following-up with them to ensure whatever medications they have been prescribed have been effective.
“We need to listen to our patients and appreciate not just what their symptoms are, but what impact they’re having on them and use those as important metrics to assess the impact of whatever treatments we’re using,” he said. – by Alex Young
Disclosures: The authors report no relevant financial disclosures.