Carpio Daniel, López-Sanromán Antonio, Calvet Xavier, Romero Cristina, Cea-Calvo Luis, Juliá Berta, Argüelles-Arias Federico
aDepartment of Gastroenterology, Pontevedra University Hospital, Biomedical Research Institute (IBI), SERGAS, Pontevedra bDepartment of Gastroenterology and Hepatology, Head Gastroenterology Division, Hospital Ramón y Cajal cNet Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd) dDepartment of Medical Affairs, Merck Sharp & Dohme, Madrid eDepartment of Medicine, Autónoma University of Barcelona fDigestive Diseases Unit, Parc Taulí University Health Corporation, Sabadell gDepartment of Gastroenterology, Hospital Virgen Macarena, Seville, Spain.
Eur J Gastroenterol Hepatol. 2016 Sep;28(9):1056-64. doi: 10.1097/MEG.0000000000000658.
Ulcerative colitis (UC) conditions patients' everyday life. With this survey, we aimed to assess the perceived disease burden, preferred treatment attributes, and treatment satisfaction reported by Spanish UC patients.
Consecutive unselected UC patients aged at least 18 years were recruited from outpatient hospital clinics. Patients completed the survey at home, returning it by postmail. With test-like questions, they described UC behavior, preferences, and satisfaction with treatment.
Of 585 patients invited, 436 (75%) returned the survey (mean age 46 years, 53% men). Of these, 47.1% described their disease during the past year as 'controlled or nearly controlled', 28.0% as 'symptoms not impairing everyday life,' and 24.9% 'disruptive symptoms'. Only 8.7% reported the complete absence of symptoms during the previous year, and 18.8, 30.7, and 47.4%, respectively, described at least one hospital admission, emergency room visit, or nonscheduled visit because of UC activity. Urgency of defecation was the most disruptive symptom. The most important therapy attribute was continuous control of symptoms (44.6%). Most patients (78.8%) were 'very satisfied' or 'satisfied' with current treatment, even those reporting a high burden of symptoms.
Half of the patients considered their UC as 'controlled or nearly controlled' and the degree of satisfaction with their therapies was high. However, they reported a high burden of symptoms and resource consumption during the previous year. These findings indicate that patients may get used to living with symptoms, underestimating the potential of therapy for achieving a complete remission. Urgency of defecation was mentioned as highly disrupting and should probably be included in scores and patient-reported outcomes.
溃疡性结肠炎(UC)影响患者的日常生活。通过本次调查,我们旨在评估西班牙UC患者报告的疾病负担感受、偏好的治疗属性以及治疗满意度。
从医院门诊连续招募年龄至少18岁的未经过筛选的UC患者。患者在家中完成调查问卷,并通过邮寄方式返还。通过类似测试的问题,他们描述了UC的行为、偏好以及对治疗的满意度。
在邀请的585名患者中,436名(75%)返还了调查问卷(平均年龄46岁,男性占53%)。其中,47.1%的患者将过去一年的疾病描述为“得到控制或接近控制”,28.0%为“症状未影响日常生活”,24.9%为“症状具有干扰性”。只有8.7%的患者报告上一年完全没有症状,分别有18.8%、30.7%和47.4%的患者描述因UC活动至少有一次住院、急诊就诊或非计划就诊。排便急迫感是最具干扰性的症状。最重要的治疗属性是症状的持续控制(44.6%)。大多数患者(78.8%)对当前治疗“非常满意”或“满意”,即使是那些报告症状负担较重的患者。
一半的患者认为其UC“得到控制或接近控制”,对治疗的满意度较高。然而,他们报告上一年症状负担和资源消耗较高。这些发现表明患者可能习惯了带着症状生活,低估了治疗实现完全缓解的潜力。排便急迫感被提及为极具干扰性,可能应纳入评分和患者报告结局中。