Making a case for patient-reported outcomes in clinical inflammatory bowel disease practice

November 30, 2018|GI and Hepatology News

Erica R. Cohen, MD;Gil Y. Melmed, MD, AGAF

The following are novel, potentially useful measures to consider for clinical use. The 13-item IBD-Control Questionnaire provides a rapid and user-friendly assessment of disease control from the patient’s perspective.²⁵ Capturing physical symptoms and social function, it includes a visual analog scale of perceived disease control. It is practical and may identify patients in a quiescent state. This is for clinicians looking to home in on individual concerns or triage the urgency of a follow-up appointment. The IBD Disk is a shortened visual adaptation of the validated IBD-Disability Index.²²Patients score their level of agreement with statements regarding pain, defecation, social interactions, education, work, sleep, energy, emotions, body image, sexual function, and joint pain over the previous week. The visual feedback allows patients and physicians to see changes in disease burden over time, highlight areas of persistent impairment, and try to improve medication adherence. This may be useful for practices with few readily available ancillary services, such as a social worker or dedicated IBD nurse.

Conclusions

As therapies for IBD improve, so should standards of patient-centered care. Clinicians must actively seek and then listen to the concerns of patients and be able to address the multiple facets of living with a chronic disease. PROs empower patients, helping them identify important topics for discussion at the clinical visit. This affords clinicians a better understanding of primary patient concerns before the visit, and potentially improves the quality and value of care. At first, the process of incorporating PROs into a busy clinical practice may be challenging, but targeted treatment plans have the potential to foster a better patient – and physician – experience.

Content from this column was originally published in the “Practice Management: The Road Ahead” section of Clinical Gastroenterology and Hepatology (2018;16[5]:603-7).

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