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J Crohns Colitis. 2019 Feb 21. pii: jjz035. doi: 10.1093/ecco-jcc/jjz035. [Epub ahead of print]

Perceived Quality of Care is associated to disease activity, quality of life, work productivity and gender but not disease phenotype: a prospective study in a high-volume IBD center.

Author information

1
First Department of Medicine, Semmelweis University, Budapest, Hungary.
2
Inflammatory Bowel Disease center, Division of Gastroenterology, McGill University Health Centre (MUHC), Montreal, Quebec, Canada.

Abstract

BACKGROUND AND AIMS:

Measuring quality of care (QoC) in inflammatory bowel diseases (IBD) has become increasingly important, yet complex assessment of QoC from the patients' perspective is rare. We evaluated perceived QoC using the Quality of Care Through the Patient's Eyes - IBD (QUOTE-IBD) questionnaire, and investigated associations between QoC, disease phenotype, work productivity and health-related quality of life (HRQoL) in a high-volume IBD center.

METHODS:

Consecutive patients attending McGill University Health Centre (MUHC)-IBD Center completed the QUOTE-IBD, Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD-Control and Work Productivity and Activity Impairment (WPAI) questionnaires. The QUOTE-IBD comprises 23 questions, each rated by a quality impact (QI) score. QI scores were calculated for the evaluation of IBD-specialists, general practitioners (GPs) and hospital care.

RESULTS:

525 patients completed the questionnaire. Total QI scores for IBD-specialists, GPs and hospital care were 8.57, 8.70 and 8.33, respectively. The lowest QI scores were related to 'accessibility' for both IBD specialists and GPs. Female gender, current disease activity, poor HRQoL (SIBDQ score ≤50) and poor disease control (IBD-Control score <13) were associated with lower mean QI scores (p<0.001 for all). Disease phenotype was not associated with QI scores in either CD or UC (p=0.69, p=0.791). An inverse correlation was found between total QI scores and work productivity loss (IBD-specialist: p<0.001; GP: p=0.004).

CONCLUSIONS:

Overall patient satisfaction with QoC was good, however improving patient accessibility is warranted. Disease phenotype was not associated with patient satisfaction, while female gender, current disease activity, HRQoL and work productivity loss were associated with patients' quality assessment, underlining that perceived QoC could be partly subjective to disease control and quality of life.

KEYWORDS:

Crohn’s disease; IBD; disease control; quality of care; quality of life; ulcerative colitis; work productivity

PMID:
30793162
DOI:
10.1093/ecco-jcc/jjz035

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