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评估影响医疗服务提供者治疗选择的克罗恩病和溃疡性结肠炎的症状及临床特征。

Evaluation of the Symptoms and Clinical Characteristics of Crohn's Disease and Ulcerative Colitis That Affect Healthcare Providers' Treatment Choices.

作者信息

Hunter Gibble Theresa, Sweeney Carolyn, Wolin Daniel, McSorley David, Wang Jinyi, Moses Richard, Dubinsky Marla

机构信息

Eli Lilly and Company, Medical Affairs, Indianapolis, IN, USA.

RTI Health Solutions, Research Triangle Park, NC, USA.

出版信息

Crohns Colitis 360. 2024 Oct 5;6(4):otae053. doi: 10.1093/crocol/otae053. eCollection 2024 Oct.

Abstract

BACKGROUND

Treatment of inflammatory bowel disease-Crohn's disease (CD) and ulcerative colitis (UC)-is dependent on healthcare providers' (HCPs') clinical assessment of patient symptoms. We therefore evaluated which CD and UC symptoms impact HCPs' treatment choices and assessed the impact of those symptoms on treatment decision-making. We also examined the role of complete control (mucosal/histologic healing, clinical remission, no bowel urgency) in treatment decision-making, considerations for dose escalation or switching treatments, and HCPs' willingness to use the Urgency Numeric Rating Scale (NRS) to assess bowel urgency severity.

METHODS

We conducted an observational, cross-sectional, self-administered survey among HCPs ( = 459, across types/specialties) who work in direct patient care and treat patients with CD and UC in the United States. Data were collected from eligible participants between November 21, 2022, and December 6, 2022, and responses were summarized through descriptive statistics.

RESULTS

For CD and UC, the symptoms of greatest importance when deciding on the course of treatment included cramping or abdominal pain, rectal bleeding, diarrhea, anemia, weight loss, and bowel urgency. Furthermore, most HCPs ranked rectal bleeding, clinical remission, abdominal pain, and complete control as "very" to "extremely" important in decisions about the course of treatment, dose escalation, or switching treatments. In total, 22.9% of HCPs indicated that they use the Urgency NRS, while 89.3% were at least somewhat willing to use it in the future.

CONCLUSIONS

Our study provides real-world insights into the symptoms and clinical characteristics that most impact HCPs' treatment choices for CD and UC in clinical practice.

摘要

背景

炎症性肠病(克罗恩病[CD]和溃疡性结肠炎[UC])的治疗取决于医疗保健提供者(HCP)对患者症状的临床评估。因此,我们评估了哪些CD和UC症状会影响HCP的治疗选择,并评估了这些症状对治疗决策的影响。我们还研究了完全控制(黏膜/组织学愈合、临床缓解、无肠道急迫感)在治疗决策、剂量增加或换药考虑中的作用,以及HCP使用急迫数字评定量表(NRS)评估肠道急迫感严重程度的意愿。

方法

我们对在美国直接参与患者护理并治疗CD和UC患者的HCP(共459名,涵盖不同类型/专业)进行了一项观察性横断面自填式调查。在2022年11月21日至2022年12月6日期间收集符合条件参与者的数据,并通过描述性统计对回答进行总结。

结果

对于CD和UC,决定治疗方案时最重要的症状包括绞痛或腹痛、直肠出血、腹泻、贫血、体重减轻和肠道急迫感。此外,大多数HCP将直肠出血、临床缓解、腹痛和完全控制在治疗方案、剂量增加或换药决策中列为“非常”至“极其”重要。总体而言,22.9%的HCP表示他们使用急迫NRS,而89.3%的HCP至少在某种程度上愿意在未来使用它。

结论

我们的研究提供了关于在临床实践中对HCP治疗CD和UC的选择影响最大的症状和临床特征的真实见解。

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