Perceptions of Physicians and Patients Differ on the Impact of Colitis

A nationwide survey has revealed that almost three out of four patients with ulcerative colitis (UC) consider that feeling unwell is just a part of life; however, the gastroenterologists estimate this to be true for only 37 pct of their UC patients.

These results came from a nationwide series of surveys, titled “UC: NORMAL (New Observations on Remission Management and Lifestyle).

It was led by David Rubin, MD, a gastroenterologist and associate professor of medicine at the University of Chicago Medical Center, who helped design the surveys.

“Before these surveys, patient and physician views on UC’s impact had not been compared and the ‘real-life’ impact of UC had not been explored to this extent,” said Dr. Rubin.

He added: “This series of surveys brings to light some challenges for the UC community: patients accept a high level of disruption from UC on their lives; physician and patient views regarding the impact of UC are not in alignment; and compliance with medications requiring multiple daily dosing is a challenge.”

Between February and March 2007 the UC: NORMAL surveys were conducted online.

At the time the surveys were conducted (prior to the availability of a once-daily mesalamine), patients reported that the medication dosing schedules were a little too difficult for them.

It was reported that around 46pct of patients had not taken all of their medication in the past week and 41pct of gastroenterologists believed their patients were not sticking to their medications.

Noticeably, 83pct of patients reported they would be ready to change to a new medication provided their physician advised that they do so, and 89pct of patients reported that they would prefer to try a once-daily 5-ASA medication.

The survey results revealed that some gastroenterologists might underestimate the level of disruption UC can have on patient lives.

For example, 42pct of patients surveyed reported symptoms of UC led to some disruption to their everyday activities, although physicians estimate that this is true for just 17 pct of patients.

Beliefs on flare frequency also differ between these physicians and patients. UC patients surveyed reported to have experienced an average of eight disease flares per year.

Also, the frequency of disease flares was underestimated by physicians: 58pctof gastroenterologists estimated that patients with mild UC will experience only one flare-up per year; 40pct of gastroenterologists estimate patients with moderate UC will experience two flare-ups per year and 30pct of gastroenterologists estimate three flare-ups; while 22pct of gastroenterologists estimate patients with severe UC will experience six or more flare-ups per year.

It was concluded that many patients find it difficult to adhere to multi-dose medication schedules and have accepted frequent flares, symptoms, and disruptions as normal instead of re-examining their disease management strategies and helping to improve compliance.

“Improved physician-patient communication and more convenient medication dosing regimens, such as once-daily formulations, could result in better disease control and we believe, improved quality of life for those who suffer from UC," said Dr. Rubin.

The results of this nationwide series of surveys were presented at the 2007 Crohn’s & Colitis Foundation’s 6th Annual Advances in the Inflammatory Bowel Diseases conference.

Source-ANI
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