Identifying and Predicting the Goals and Concerns Prioritised by Individuals with Inflammatory Bowel Disease

摘要

Background and Aims In order to provide high-quality care, providers need to understand their patients' goals and concerns. This study aims to identify and predict the goals and concerns prioritised by patients with inflammatory bowel disease IBD in the outpatient setting. Methods Mixed-methods analysis was performed to identify the types, frequencies, and predictors of IBD patients' goals and concerns using 4873 surveys collected over 2016-2019 at 25 gastroenterology clinics across the USA participating in the Crohn's Colitis Foundation's IBD Qorus Learning Health System. Results Patients with IBD most often prioritised goals and concerns related to symptoms/disease activity 50 and clinical course/management 20, whereas psychosocial/quality of life 12 and medication 6 concerns were less frequent. Females (odds ratio OR 22.1, 95 confidence interval CI 5.3-91.5) and patients in clinical remission OR 2.2, 95 CI 1.2-4.1 were more likely to prioritise family planning. Patients >60 years old OR 3.1, 95 CI 1.5-6.5 and patients with active disease OR 3.2, 95 CI 1.4-7.6 were more often concerned about travelling. Smokers were more often concerned about nutrition OR 4.2, 95 CI 1.9-9.2. Surgery was more often a concern of patients with perianal Crohn's disease OR 2.1, 95 CI 1.2-3.5, active disease OR 1.9, 95 CI 1.1-3.4, and those with recent hospitalisations OR 2.5, 95 CI 1.2-5.4. Conclusions IBD patients prioritised the remission of physical symptoms as treatment goals and they were less frequently concerned about medications and their side effects. Patients' demographics, IBD characteristics, and health care utilisation patterns can predict specific types of concerns/goals.