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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

Proportion of respondents reporting a change in their utility from baseline (remaining responders reported no change) at three and twelve months with the mean utility score change and 95% confidence intervals.
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pone.0139389.g002: Proportion of respondents reporting a change in their utility from baseline (remaining responders reported no change) at three and twelve months with the mean utility score change and 95% confidence intervals.

Mentions: The median overall utility score for the cohort before seeing a gastroenterologist was 0.76 (Interquartile range [IQR] 0.69 to 0.80). Three months after the gastroenterology appointment, 44% had improved utility, 42% experienced no change and 14% had worse utility (Fig 2). The mean utility increased by 0.04 to 0.80 (IQR 0.62 to 1.00). One year after the appointment, a third of responders had improved utility from the baseline, a third experienced no change and a third had worse utility (Fig 2). The mean utility fell by 0.07 from the 3 month peak to 0.73 (IQR 0.65 to 0.76), a 0.04 decrease from the pooled baseline. None of these changes were statistically significant, however. When responses at three and twelve months were compared to the baseline response of the same patients, as opposed to the whole cohort initially recruited, the mean utility three months after seeing a gastroenterologist had increased by 0.06 (95% CI -0.01 to 0.14), but this change reduced to 0.00 (95% CI -0.16 to 0.16) after a year (Table 4). When the results were stratified, the two groups who showed sustained increased utility were those aged over 50 years and those referred with diarrhoea. Men and women had similar utility at baseline, at three months men has greater mean improvement but this was not maintained at one year. At baseline, utility was higher in patients aged under 30. At three months those aged over 30 years reported greater mean improvement in utility which was sustained at one year, whilst those aged under 30 reported a mean decrease in utility. None of these findings were statistically significant. No changes in utility at three or twelve months were statistically significantly different from before seeing the gastroenterologist (Table 4). Mean values have been reported in Table 3 to make the results amenable to future cohort modelling.


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)

Proportion of respondents reporting a change in their utility from baseline (remaining responders reported no change) at three and twelve months with the mean utility score change and 95% confidence intervals.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0139389.g002: Proportion of respondents reporting a change in their utility from baseline (remaining responders reported no change) at three and twelve months with the mean utility score change and 95% confidence intervals.
Mentions: The median overall utility score for the cohort before seeing a gastroenterologist was 0.76 (Interquartile range [IQR] 0.69 to 0.80). Three months after the gastroenterology appointment, 44% had improved utility, 42% experienced no change and 14% had worse utility (Fig 2). The mean utility increased by 0.04 to 0.80 (IQR 0.62 to 1.00). One year after the appointment, a third of responders had improved utility from the baseline, a third experienced no change and a third had worse utility (Fig 2). The mean utility fell by 0.07 from the 3 month peak to 0.73 (IQR 0.65 to 0.76), a 0.04 decrease from the pooled baseline. None of these changes were statistically significant, however. When responses at three and twelve months were compared to the baseline response of the same patients, as opposed to the whole cohort initially recruited, the mean utility three months after seeing a gastroenterologist had increased by 0.06 (95% CI -0.01 to 0.14), but this change reduced to 0.00 (95% CI -0.16 to 0.16) after a year (Table 4). When the results were stratified, the two groups who showed sustained increased utility were those aged over 50 years and those referred with diarrhoea. Men and women had similar utility at baseline, at three months men has greater mean improvement but this was not maintained at one year. At baseline, utility was higher in patients aged under 30. At three months those aged over 30 years reported greater mean improvement in utility which was sustained at one year, whilst those aged under 30 reported a mean decrease in utility. None of these findings were statistically significant. No changes in utility at three or twelve months were statistically significantly different from before seeing the gastroenterologist (Table 4). Mean values have been reported in Table 3 to make the results amenable to future cohort modelling.

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