Ulcerative colitis patients often have different treatment goals than their physicians
Patients with ulcerative colitis often had different perceptions of quality of life impact, treatment goals, and attitudes to therapies than their physicians in a qualitative study of communication during in-office visits.
“We assessed the dialog that took place between patients with moderate-to-severe UC and their gastroenterologists,” David T. Rubin, MD, of the department of medicine and the Inflammatory Bowel Disease Center at University of Chicago Medicine, and colleagues wrote. “We cataloged themes relating to the patient–physician interaction during the visit which encompassed: patient and physician assessment of symptoms, including QOL and emotional aspects of UC; patient and physician goals of treatment; and patient and physician attitudes toward biologic therapies for UC.”
David T. Rubin
Investigators analyzed transcripts from recorded clinic visits and follow-up interviews from 15 gastroenterologists and 40 patients in the U.S., and eight gastroenterologists and 28 patients in Europe.
They found that patients rarely spoke about the impact UC had on their QOL unless asked by their physician, and in post-visit interviews their physicians’ perception of QOL impacts completely aligned with the patients’ assessment in 40% of cases, partially aligned in 43% and did not align in 18%.
Additionally, they found that while most physicians and patients considered clinical remission to be a treatment goal, 25% of gastroenterologists in the U.S. considered absence of inflammation to be a treatment goal compared with just 3% of their patients, and this goal was not always discussed during office visits.
Further, gastroenterologists framed biologics as “a last resort,” and often adhered to guidelines in describing biologics as appropriate for patients who were refractory to conventional therapies. Patients often considered biologics as more appropriate for patients whose disease was more severe than theirs.
“Due to the chronic nature of UC and the significant impact on QOL of its symptoms, the relationship between patients and their gastroenterologists is important in understanding and implementing appropriate treatment strategies,” Rubin and colleagues wrote. “Fostering more effective relationships between patients and their physicians has been shown to enhance understanding of available treatment strategies and, in turn, led to both increased patient satisfaction and improved outcomes.” – by Adam Leitenberger
Disclosures: Rubin reports he has received consulting fees from AbbVie, Amgen, Janssen, Pfizer, Takeda and UCB, and has received research grants from AbbVie, Genentech, Janssen, Takeda and UCB. Please see the full study for a list of all other researchers’ relevant financial disclosures.