Division of Pediatric Gastroenterology, Hepatology and Nutrition, Monroe Carell Jr Children's Hospital at Vanderbilt, DOT Suite 10226, 2200 Children's Way, Nashville, TN 37232, USA.
Campaign Urging Research for Eosinophilic Diseases, Lincolnshire, IL, USA.
Clin Res Hepatol Gastroenterol. 2018 Oct;42(5):483-493. doi: 10.1016/j.clinre.2018.03.003. Epub 2018 Mar 31.
Eosinophilic gastrointestinal disorders (EGIDs) are a rare but emerging healthcare problem. Patient advocacy groups (PAGs) have an important role in representing the EGID community, and serve as valuable research partners. By leveraging the partnership between medical researchers and PAGs, we examined the unmet needs and barriers to care perceived by individuals affected by EGIDs. Next, we examined if these varied between adult EGID patients and adult caregivers of children with EGID.
Adult EGID patients and adult caregivers of children (<18 years) with EGIDs participated in this study. PAGs conducted focus groups comprised of individuals affected by EGIDs to identify domains and questions meaningful to the EGID community and this information was used to develop an online REDCap survey. The survey consisted of 58 questions across medical, healthcare, social, and emotional impact domains. It was distributed via the PAGs' web-based platforms. Demographic data, and responses to questions on a six-point Likert scale were collected and analyzed.
Of the 361 responses analyzed, 90 (25%) were from adult EGID patients and 271 (75%) were from adult caregivers. Of the applicable responses, in the medical domain only 19% of participants indicated that repeated endoscopies to monitor response to treatment was convenient. In the healthcare domain, 67% indicated that lack of insurance coverage for elemental formula was a barrier. In the social domain, only 5% of respondents reported adequate awareness of EGIDs in schools. In the emotional domain, 64% had experienced significant stress due to EGID related out-of-pocket costs. Multivariate logistic regression revealed that some of these responses varied between adult EGID patients and adult caregivers of children with EGID. The respondents indicated highest priority for improvement in the medical domain compared to other domains.
Individuals affected by EGIDs have a constellation of complex unmet needs and perceived barriers across medical, healthcare, social and emotional domains. Addressing unmet needs in the medical domain is relatively more important for the EGID community. Understanding unmet needs and barriers will likely help design improved patient-centered EGID care paradigms.
嗜酸性粒细胞性胃肠道疾病(EGID)是一种罕见但正在出现的医疗保健问题。患者权益组织(PAG)在代表 EGID 社区方面发挥着重要作用,是有价值的研究合作伙伴。通过利用医学研究人员和 PAG 之间的合作关系,我们研究了受 EGID 影响的个体所感知的未满足需求和护理障碍。接下来,我们研究了这些需求和障碍在成人 EGID 患者和儿童(<18 岁) EGID 成年照顾者之间是否存在差异。
本研究纳入了成人 EGID 患者和儿童(<18 岁) EGID 成年照顾者。PAG 组织了由受 EGID 影响的个人组成的焦点小组,以确定对 EGID 社区有意义的领域和问题,并利用这些信息开发了在线 REDCap 调查。该调查包括医疗、医疗保健、社会和情感影响领域的 58 个问题。它通过 PAG 的基于网络的平台进行分发。收集并分析了人口统计学数据以及对六点李克特量表问题的回答。
在分析的 361 份答复中,有 90(25%)来自成人 EGID 患者,有 271(75%)来自儿童(<18 岁) EGID 成年照顾者。在适用的答复中,仅 19%的参与者表示反复进行内窥镜检查以监测治疗反应是否方便。在医疗保健领域,67%的人表示缺乏对元素配方的保险覆盖是一个障碍。在社会领域,只有 5%的受访者报告称在学校对 EGIDs 有足够的认识。在情感领域,64%的人因与 EGID 相关的自付费用而经历了严重的压力。多变量逻辑回归显示,这些反应中的一些在成人 EGID 患者和儿童(<18 岁) EGID 成年照顾者之间存在差异。与其他领域相比,受访者表示对医疗领域的改进具有最高优先级。
受 EGID 影响的个体在医疗、医疗保健、社会和情感领域都存在一系列复杂的未满足需求和感知障碍。解决医疗领域的未满足需求对 EGID 社区相对更为重要。了解未满足的需求和障碍可能有助于设计以患者为中心的改进 EGID 护理模式。