P278. Aspects that determine patient satisfaction in the management of mild to moderate ulcerative colitis: a Delphi study of patients and physicians
F. Casellas1, D. Ginard2, S. Riestra3, A.J. Blasco4, P. Lazaro4, 1Hospital Universitari Vall d'Hebron, Unitat Atenció Crohn-Colitis, Barcelona, Spain, 2Hospital Universitario Son Espases, Gastroenterology Department, Palma de Mallorca, Spain, 3Hospital Universitario Central de Asturias, Gastroenterology Department, Oviedo, Spain, 4Advanced Techniques in Health Services Research (TAISS), Research, Madrid, Spain
For the management of mild-to-moderate ulcerative colitis (UC) effective treatments are available; however, factors that determine patient satisfaction are slightly known. The purpose of this study is to understand perceptions and attitudes of patients with mild-to-moderate UC and specialists in inflammatory bowel disease on relevant aspects determining patient satisfaction in the management of their UC.
A two-round Delphi method was performed with a panel of physicians and patients. The first round questionnaire was developed from literature search and findings arising from a qualitative study (discussion group) with patients suffering mild-to-moderate UC. The patients final questionnaire was composed of 258 items grouped into 6 sections: diagnosis, follow-up, and treatment (including mesalazines, corticosteroids and immunomodulators). This questionnaire was sent to 20 patients. Another questionnaire, was sent to 22 physicians, which included the 258 items of the patients questionnaire and 32 additional items exclusively for physicians. Relevance of items on patient satisfaction was scored on a scale of 1 (least important) to 9 (very important). Agreement among panellists was measured according to RAND/UCLA's IPRAS methodology. Concordance between physicians and patients was defined as parity in relevance level (very high, high, medium and low). Items rated with very high relevance by patients, or by physicians on specific physicians items, comprise the recommendations included in this study.
Most issues analyzed, although not all, are considered by physicians and patients with similar levels of relevance. Patients gave greater relevance to the follow-up of moderate flares at hospital rather than at primary care or specialized outpatient centre, and to be informed about aspects such as diet, impact of UC on their health and lifestyle, drug contraindications and interactions. For physicians and patients, efficacy, safety, and improved quality of life obtained with the treatments are highly relevant. Physicians consider that improvement of patient satisfaction could be achieved by reducing dose frequency, amount and size of tablets, while the most relevant aspects for patients are avoid rectal administration and increasing usage of oral medication.
Findings of this study contribute to a better understanding of relevant aspects that influence satisfaction of patients with mild-to-moderate UC, and could support developing strategies and interventions to improve the patients satisfaction.