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Change in Quality of Life for Patients with Irritable Bowel Syndrome following Referral to a Gastroenterologist: A Cohort Study.

Canavan C, West J, Card T - PLoS ONE (2015)

Bottom Line: Median global QoL at baseline was 67.5 (Interquartile range [IQR] 50.0 to 80.0), with a mean increase of 3.25 (95% confidence interval [CI] -5.38 to 11.88) three months later and a mean decrease of -1.82 (95% CI -16.01 to 12.38) after one year.Patients experienced a small but not statistically significant increase in QoL and utility three months after seeing a gastroenterologist for IBS, which was not maintained.Gastroenterology referral does not appear to appreciably improve Qol for most people with IBS.

View Article: PubMed Central - PubMed

Affiliation: Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital Campus, Nottingham, England, United Kingdom.

ABSTRACT

Background: Irritable bowel syndrome (IBS), a chronic functional condition, considerably reduces quality of life (QoL) and referral to gastroenterology is common. Until now, however, the impact of seeing a gastroenterologist for IBS on patients' QoL and utility has not been assessed.

Methods: Patients referred with "probable IBS" to the Nottingham Treatment Centre between October 2012 and March 2014 were invited to complete a QoL questionnaire (EuroQol-5 Dimension) before their first appointment. Patients with confirmed IBS who completed this baseline assessment were sent follow-up questionnaires three and twelve months later. Global QoL and utility were measured at each time point and change from baseline calculated. Paired t-tests analysed the significance of any change.

Results: Of 205 invited patients, 69 were eligible and recruited. Response at three and twelve months was 45% and 17% respectively. Median global QoL at baseline was 67.5 (Interquartile range [IQR] 50.0 to 80.0), with a mean increase of 3.25 (95% confidence interval [CI] -5.38 to 11.88) three months later and a mean decrease of -1.82 (95% CI -16.01 to 12.38) after one year. The median utility at baseline was 0.76 (IQR 0.69 to 0.80), with a mean increase of 0.06 (95%CI -0.01 to 0.14) at three months and no change, 0.00 (-0.16 to 0.16), after one year.

Conclusion: Patients experienced a small but not statistically significant increase in QoL and utility three months after seeing a gastroenterologist for IBS, which was not maintained. Gastroenterology referral does not appear to appreciably improve Qol for most people with IBS.

No MeSH data available.


Related in: MedlinePlus

Flowchart showing the recruitment process.
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pone.0139389.g001: Flowchart showing the recruitment process.

Mentions: We invited 205 patients to participate after screening referral letters. Of these, sixty declined, 31 did not have an initial questionnaire collected before their appointment as required in our protocol and 22 did not meet the eligibility criteria. Ninety-two patients completed the first questionnaire. Review of their notes after the appointment found that 5 had been seen previously by gastroenterologist and 18 were not diagnosed with IBS. This left 69 patients with IBS referred to see a gastroenterologist for the first time who were recruited to our study. At three months, 29 (42%) returned a follow-up questionnaire and at one year 12 (17%) returned a further questionnaire (Fig 1). Table 1 shows the demographic details of all invited patients, the initial recruits and the responders at each time point. From those invited, 41% of referrals already had a diagnosis of IBS and over half were referred with diarrhoea. Over two thirds of the patients were female, with 73% of those invited and 69% of responders being female. The mean age of all invited patients was 41.4 years (95% CI 39.3 to 43.6) and the mean age of those participating was 40.2 years (95% CI 37.2 to 43.3). The proportions of patients in each age group differed between those invited and the participant sample, with the young somewhat underrepresented amongst participants. Twenty-percent of the responders were diagnosed with a condition other than IBS following their clinic appointment and investigations (Table 2). Of these patients, 35% (8 patients) had a previous diagnosis of IBS. Referral symptoms in those diagnosed with something other than IBS were proportionate to the total sample invited (Table 1).


Change in Quality of Life for Patients with Irritable Bowel Syndrome following Referral to a Gastroenterologist: A Cohort Study.

Canavan C, West J, Card T - PLoS ONE (2015)

Flowchart showing the recruitment process.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591971&req=5

pone.0139389.g001: Flowchart showing the recruitment process.
Mentions: We invited 205 patients to participate after screening referral letters. Of these, sixty declined, 31 did not have an initial questionnaire collected before their appointment as required in our protocol and 22 did not meet the eligibility criteria. Ninety-two patients completed the first questionnaire. Review of their notes after the appointment found that 5 had been seen previously by gastroenterologist and 18 were not diagnosed with IBS. This left 69 patients with IBS referred to see a gastroenterologist for the first time who were recruited to our study. At three months, 29 (42%) returned a follow-up questionnaire and at one year 12 (17%) returned a further questionnaire (Fig 1). Table 1 shows the demographic details of all invited patients, the initial recruits and the responders at each time point. From those invited, 41% of referrals already had a diagnosis of IBS and over half were referred with diarrhoea. Over two thirds of the patients were female, with 73% of those invited and 69% of responders being female. The mean age of all invited patients was 41.4 years (95% CI 39.3 to 43.6) and the mean age of those participating was 40.2 years (95% CI 37.2 to 43.3). The proportions of patients in each age group differed between those invited and the participant sample, with the young somewhat underrepresented amongst participants. Twenty-percent of the responders were diagnosed with a condition other than IBS following their clinic appointment and investigations (Table 2). Of these patients, 35% (8 patients) had a previous diagnosis of IBS. Referral symptoms in those diagnosed with something other than IBS were proportionate to the total sample invited (Table 1).

Bottom Line: Median global QoL at baseline was 67.5 (Interquartile range [IQR] 50.0 to 80.0), with a mean increase of 3.25 (95% confidence interval [CI] -5.38 to 11.88) three months later and a mean decrease of -1.82 (95% CI -16.01 to 12.38) after one year.Patients experienced a small but not statistically significant increase in QoL and utility three months after seeing a gastroenterologist for IBS, which was not maintained.Gastroenterology referral does not appear to appreciably improve Qol for most people with IBS.

View Article: PubMed Central - PubMed

Affiliation: Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital Campus, Nottingham, England, United Kingdom.

ABSTRACT

Background: Irritable bowel syndrome (IBS), a chronic functional condition, considerably reduces quality of life (QoL) and referral to gastroenterology is common. Until now, however, the impact of seeing a gastroenterologist for IBS on patients' QoL and utility has not been assessed.

Methods: Patients referred with "probable IBS" to the Nottingham Treatment Centre between October 2012 and March 2014 were invited to complete a QoL questionnaire (EuroQol-5 Dimension) before their first appointment. Patients with confirmed IBS who completed this baseline assessment were sent follow-up questionnaires three and twelve months later. Global QoL and utility were measured at each time point and change from baseline calculated. Paired t-tests analysed the significance of any change.

Results: Of 205 invited patients, 69 were eligible and recruited. Response at three and twelve months was 45% and 17% respectively. Median global QoL at baseline was 67.5 (Interquartile range [IQR] 50.0 to 80.0), with a mean increase of 3.25 (95% confidence interval [CI] -5.38 to 11.88) three months later and a mean decrease of -1.82 (95% CI -16.01 to 12.38) after one year. The median utility at baseline was 0.76 (IQR 0.69 to 0.80), with a mean increase of 0.06 (95%CI -0.01 to 0.14) at three months and no change, 0.00 (-0.16 to 0.16), after one year.

Conclusion: Patients experienced a small but not statistically significant increase in QoL and utility three months after seeing a gastroenterologist for IBS, which was not maintained. Gastroenterology referral does not appear to appreciably improve Qol for most people with IBS.

No MeSH data available.


Related in: MedlinePlus