International Perspectives on Management of Inflammatory Bowel Disease: Opinion Differences and Similarities Between Patients and Physicians From the IBD GAPPS Survey

Inflamm Bowel Dis. 2021 Jan 29;izab006. doi: 10.1093/ibd/izab006. Online ahead of print.

David T Rubin 1, Charles Sninsky 2, Britta Siegmund 3, Miquel Sans 4, Ailsa Hart 5, Brian Bressler 6, Yoram Bouhnik 7, Alessandro Armuzzi 8, Anita Afzali 9


Author information

  • 1University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, Illinois, USA.
  • 2Digestive Disease Associates, Gainesville, Florida, USA.
  • 3Charité - Universitätsmedizin Berlin, Berlin, Germany.
  • 4Gastroenterology Department/ISADMU, Centro Médico Teknon, Barcelona, Spain.
  • 5St. Mark's Hospital, London, UK.
  • 6University of British Columbia, Vancouver, British Columbia, Canada.
  • 7Inserm et Université Paris, Paris, France.
  • 8Fondazione Policlinico A. Gemelli IRCCS-Universita' Cattolica, Rome, Italy.
  • 9The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.


Background: Inflammatory bowel diseases (IBD), including Crohn disease (CD) and ulcerative colitis (UC), are complex disorders with multiple comorbidities. We conducted international patient and physician surveys to evaluate current experiences and perceptions of patients with CD or UC and physicians who treat IBD.

Methods: The IBD Global Assessment of Patient and Physician Unmet Need Surveys comprised a patient survey and a physician survey, fielded in North America and Europe between August 16, 2019, and November 10, 2019. Adults with CD or UC (targeted 1:1 ratio) were recruited from physicians, patient advocacy groups, and recruitment panels; physicians were recruited by recruitment agencies and panels.

Results: In total, 2398 patients with IBD (1368 CD, 1030 UC) and 654 physicians completed surveys. Anxiety and depression were the most common comorbidities among patients with IBD. Patients and physicians were generally aligned on treatment goals and patient-physician communication. Patients with IBD reported high quality-of-life impact by rectal urgency and need to use the toilet, which were rated as lower-impact by physicians. Patients defined remission based on symptoms; physicians defined remission based primarily on clinical tests. Patients expected current treatments to control their disease for a longer duration than did physicians. Patients expressed more concern about corticosteroid use compared with physicians; many physicians reported prescribing corticosteroids for more than 4 months per year in some patients.

Conclusions: Patients could benefit from education about disease remission and expectations for current therapies. High corticosteroid use is concerning to patients, and physicians should minimize the use of corticosteroids for extended periods of time.

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