Patient. 2021 Mar 12. doi: 10.1007/s40271-021-00500-8. Online ahead of print.

Xavier Calvet ¹, Fransesc Casellas ², Roberto Saldaña ³, Daniel Carpio ⁴, Miguel Mínguez ⁵, Isabel Vera ⁶, Laura Marín ⁷, Berta Juliá ⁸, GETECCU, GETEII, ACCU

Author information

• ¹Digestive Diseases Unit, Corporació Sanitaria Universitària Parc Taulí, Sabadell, Spain.
• ²Crohn-Colitis Care Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
• ³ACCU, Madrid, Spain.
• ⁴Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Biomédica Galicia Sur (IBI), Pontevedra, Spain.
• ⁵Hospital Clínico Universitario, University of Valencia, Valencia, Spain.
• ⁶Servicio de Aparato Digestivo, Hospital Universitario de Puerta de Hierro, Majadahonda, Madrid, Spain.
• ⁷Servei de Malalties Digestives, Hospital Germans Trias I Pujol, Barcelona, Spain.
• ⁸Medical Department MSD, Madrid, Spain. berta_julia@merck.com.

Abstract

Background: Measuring quality of care (QoC) from a patient's perspective is becoming increasingly important in inflammatory bowel disease.

Objective: The objective of this study was to determine whether patients' evaluations of QoC correlate with better inflammatory bowel disease outcomes.

Methods: A survey including patients' characteristics, a decalogue of QoC indicators, and self-reported disease outcomes was completed by Spanish patients with inflammatory bowel disease. A QoC index (QoCI) was constructed with the sum of the "yes" answers in the decalogue. We evaluated the correlation of QoCI with outcomes. A sub-analysis comparing patients with high QoCI vs those with low QoCI was performed (QoCI = 10 or ≤ 7).

Results: Seven hundred and eighty-eight questionnaires were analyzed. Mean age of participants was 43.4 years (63% women). Mean QoCI was 8.1 (± 2.4). The QoCI correlated significantly with activity of the disease, number of flares, emergency/unscheduled visits, and disease control. Patients scoring in the first QoCI quartile reported a decreased rate of moderate/severe disease (34.8% vs 55.3%, p < 0.001), fewer numbers of flares (p < 0.001), and fewer emergency/unscheduled visits (p < 0.001) compared with those in the lower QoCI quartile. The high QoC group also reported better disease control.

Conclusions: Patient-evaluated QoC correlates with better outcomes. Evaluation of QoC by patients may be useful to detect inadequate care and improve inflammatory bowel disease outcomes.