Patient Experiences in the Management of Inflammatory Bowel Disease: A Qualitative Study

Author:

Mirza Raza M12,MacKean Gail3,Shaffer Seth R45,Sewitch Maida J6ORCID,Heisler Courtney7,McLeod Justine8,Habashi Peter8,MacDonald Karen V3,Barker Karis3,Nguyen Geoffrey C8ORCID,Marshall Deborah A3

Affiliation:

1. University of Toronto, Factor-Inwentash Faculty of Social Work, Institute for Life Course and Aging , Canada

2. National Initiative for the Care of the Elderly (NICE) , Canada

3. Department of Community Health Sciences Cumming School of Medicine, University of Calgary , Calgary , Canada

4. University of Manitoba IBD Clinical and Research Center , Canada

5. Internal Medicine, University of Manitoba , Canada

6. Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre , Canada

7. Nova Scotia Collaborative IBD Program, Division of Digestive Care and Endoscopy, QEII Health Sciences Centre , Canada

8. Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto Department of Medicine , Canada

Abstract

Abstract Background Inflammatory bowel disease (IBD) can lead to substantial impairments of quality-of-life. Clinical guidelines and quality indicators aid physicians in practice but may not reflect the perspectives and experiences of patients with IBD. To address this, the objectives of this study were to understand patient experiences with IBD care and to explore priorities. Methods Based on a convenience sample of 36 participants, five focus groups were completed at four sites across Canada. Data were analyzed using a deductive thematic analysis approach to assess emergent themes and variability in participants’ experiences. Results Our results are organized by themes of structure, process and outcomes to illustrate common issues with respect to how care is organized in the healthcare system, how patients receive and experience care and how patients perceive the outcomes of their care. Our results frame a health systems quality approach that signal needed improvements in access to care, the need for innovation with respect to virtual medicine, the potential expansion of multidisciplinary team-based care and the importance of addressing the psychosocial dimensions for patients with IBD and their caregivers in order to better deliver patient-centred care. Conclusions The issues identified have the potential to impact priority areas in the system, IBD care delivery, and how outcomes can be improved by focusing on ‘lived experience’ and patient-centred care. The differing values and perspectives of all those involved in caring for patients with IBD underscore the importance of good communication with patients, caregivers and family members, as well as staying responsive to evolving needs.

Funder

Crohn’s and Colitis Canada

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical)

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