Comparative quantitative survey of patient experience in Barrett’s oesophagus and other gastrointestinal disorders

Britton, James; Taxiarchi, Paraskevi; Martin, Glen P.; Willert, Robert P.; Horne, Maria; Hamdy, Shaheen; McLaughlin, John; Ang, Yeng

doi:10.1136/bmjgast-2019-000357

Cited by 9 publications

(37 citation statements)

References 51 publications

(64 reference statements)

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“…These findings are inconsistent with that of Britton et al. who found 69.5% levels of >10 on the CWS 7 …”

Section: Discussioncontrasting

confidence: 97%

“…In accordance with the present result, the study of Britton et al. 7 demonstrated 10% moderate to severe acid regurgitation in comparison with the 6.4% found in the present study. The number of moderate to severe symptoms of heartburn were comparable between the expert centers in the Netherlands and an expert center in the UK (3.5% vs. 2.2% 7 ).…”

Section: Discussionsupporting

confidence: 93%

“…Quantitative data confirm associations between decreased HRQoL and fear of cancer, anxiety, and GI symptoms 7,10,12 . A more recent study on the prevalence of factors influencing HRQoL in patients receiving surveillance of their BE showed GERD symptom severity was associated with EAC cancer worry, anxiety and depression 7 . However, it is not known what factors are associated with negative illness perception by patients with the diagnosis BE.…”

Section: Introductionmentioning

confidence: 65%

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Barrett Esophagus: Quality of life and factors associated with illness perception

et al. 2022

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Background Health‐related Quality of life (HRQoL) in patients with Barrett's esophagus (BE), a premalignant condition, may be influenced by gastroesophageal reflux disease (GERD) symptoms and the risk of developing esophageal adenocarcinoma. Methods We aim to investigate HRQoL in non‐dysplastic Barrett Esophagus (NDBE) patients, identify factors associated with a negative illness perception of the diagnosis BE and compare outcomes between patients treated in a specialized BE center with non‐expert centers. In this multi‐center cross‐sectional study, HRQoL of NDBE patients were assessed using the Short Form 36, Hospital Anxiety and Depression Scale, Cancer worry Scale, and Reflux Disease Questionnaire. A multivariable, linear regression analysis was conducted to assess factors associated with illness perception (Illness perception scale) of the BE diagnosis. Outcome parameters of patients from expert centers were compared to non‐expert centers. Results A total of 859 NDBE patients (mean age 63.6% and 74.5% male), of which 640 from BE expert centers were included. BE patients scored similar or higher means (i.e. better) on generic HRQoL in comparison with a Dutch norm population. The multivariable regression model showed that cancer worry, GERD symptoms, signs of anxiety and depression, and female gender were associated with a negative illness perception of BE. GERD symptoms were reported in the minority (22.4%) of BE patients. Levels of anxiety symptoms were comparable to a Dutch norm population (mean 3.7 vs. 3.9 p 0.183) and lower for depression symptoms (mean 6.8 vs. 7.6 p < 0.001). Overall, there were no differences found on outcomes between expert centers and non‐expert centers. Conclusion NDBE patients scored similar or better on generic HRQoL, anxiety and depression than an age and gender matched norm population. The presence of cancer worry, gastrointestinal symptoms, anxiety and depression, and female gender are factors associated with a negative illness perception of the diagnosis BE.

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“…These findings are inconsistent with that of Britton et al. who found 69.5% levels of >10 on the CWS 7 …”

Section: Discussioncontrasting

confidence: 97%

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 65%

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Barrett Esophagus: Quality of life and factors associated with illness perception

et al. 2022

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“…Britton et al 59 carried out a quantitative study comparing the health-related quality of life of patients with BO, both in non-dysplastic and dysplastic cases post-treatment, with healthy patients, those with GORD and patients with colonic polyps. Eligible cases totalled 687.…”

Section: What Are the Unmet Needs Of Patients With Bo Which Could Be ...mentioning

confidence: 99%

Developing patient-orientated Barrett’s oesophagus services: the role of dedicated services

Ratcliffe

Britton

Hamdy

et al. 2022

BMJ Open Gastroenterol

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IntroductionBarrett’s oesophagus (BO) is common and is a precursor to oesophageal adenocarcinoma with a 0.33% per annum risk of progression. Surveillance and follow-up services for BO have been shown to be lacking, with studies showing inadequate adherence to guidelines and patients reporting a need for greater disease-specific knowledge. This review explores the emerging role of dedicated services for patients with BO.MethodsA literature search of PubMed, MEDLINE, Embase, Emcare, HMIC, BNI, CiNAHL, AMED and PsycINFO in regard to dedicated BO care pathways was undertaken.ResultsProspective multicentre and randomised trials were lacking. Published cohort data are encouraging with improvements in guideline adherence with dedicated services, with one published study showing significant improvements in dysplasia detection rates. Accuracy of allocation to surveillance endoscopy has been shown to hold cost savings, and a study of a dedicated clinic showed increased discharges from unnecessary surveillance. Training modalities for BO surveillance and dysplasia detection exist, which could be used to educate a BO workforce. Qualitative and quantitative studies have shown patients report high levels of cancer worry and poor disease-specific knowledge, but few studies have explored follow-up care models despite being a patient and clinician priority for research.ConclusionsCost–benefit analysis for dedicated services, considering both financial and environmental impacts, and more robust clinical data must be obtained to support this model of care in the wider health service. Greater understanding is needed of the root causes for poor guideline adherence, and disease-specific models of care should be designed around clinical and patient-reported outcomes to address the unmet needs of patients with BO.

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“…The factors 'sense of control' and 'knowledge and understanding' were measured by items of the B-IPQ. Although fear of cancer was stated as an important factor influencing HRQoL in the literature, it was only measured in one study using the CWS [38]. In another study by Rosmolen et al [21,22], the WOCS was used for assessing fear of cancer (recurrence).…”

Section: Coverage Of Factors In Hrqol Proms Relevant To Patientsmentioning

confidence: 99%

How are we measuring health-related quality of life in patients with a Barrett Esophagus? A systematic review on patient-reported outcome measurements

et al. 2021

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Purpose Barrett esophagus (BE) is associated with a significant decrease of health-related quality of life (HRQoL). Too often, patient-reported outcome measures (PROMs) are applied without considering what they measure and for which purposes they are suitable. With this systematic review, we provide researchers and physicians with an overview of all the instruments previously used for measuring HRQoL in BE patients and which PROMs are most appropriate from the patient’s perspective. Methods A comprehensive search was performed to identify all PROMs used for measuring HRQoL in BE patients, to identify factors influencing HRQoL according to BE patients, and to evaluate each PROM from a patients’ perspective. Results Among the 27 studies, a total of 32 different HRQoL instruments were identified. None of these instruments were designed or validated for use in BE patients. Four qualitative studies were identified exploring factors influencing HRQoL in the perceptions of BE patients. These factors included fear of cancer, anxiety, trust in physician, sense of control, uncertainty, worry, burden of endoscopy, knowledge and understanding, gastrointestinal symptoms, sleeping difficulties, diet and lifestyle, use of medication, and support of family and friends. Conclusion None of the quantitative studies measuring HRQoL in BE patients sufficiently reflected the perceptions of HRQoL in BE patients. Only gastrointestinal symptoms and anxiety were addressed in the majority of the studies. For the selection of PROMs, we encourage physicians and researchers measuring HRQoL to choose their PROMs from a patient perspective and not strictly based on health professionals’ definitions of what is relevant.

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Comparative quantitative survey of patient experience in Barrett’s oesophagus and other gastrointestinal disorders

Cited by 9 publications

References 51 publications

Barrett Esophagus: Quality of life and factors associated with illness perception

Barrett Esophagus: Quality of life and factors associated with illness perception

Developing patient-orientated Barrett’s oesophagus services: the role of dedicated services

How are we measuring health-related quality of life in patients with a Barrett Esophagus? A systematic review on patient-reported outcome measurements

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