Providing Hospitalized Ulcerative Colitis Patients With Practice Guidelines Improves Patient-Reported Outcomes

Abstract

Background and aims Variation in care has been demonstrated among hospitalized patients with ulcerative colitis. Guidelines aim to reduce variation; however, it is known that the uptake of guidelines by physicians is variable. Providing patients with guidelines is a strategy that has not been extensively studied in inflammatory bowel disease (IBD). Our aim was to evaluate the impact of a patient-directed educational intervention that included treatment guidelines among hospitalized ulcerative colitis patients. Methods We performed a quality improvement, cluster-randomized trial at seven tertiary IBD centres. Sites were randomized to implement an educational intervention or standard care for a 6-month period between January 2017 and January 2018. The educational intervention consisted of a patient-directed video that provided a summary of inpatient management guidelines for ulcerative colitis. Primary outcome measures included the length of stay and colectomy at discharge and 6 months. Patient-reported outcomes included trust in physician and patient satisfaction at discharge and at 6 months. Results Ninety-one patients were enrolled. No statistically significant differences in length of stay or colectomy were noted. Patients who received the intervention had higher trust in physician as measured by Trust in Physician Score at discharge (69.5 vs. 62.6, P = 0.028) and at 6 months (77.7 vs. 68, P = 0.008). Patient satisfaction as measured by the CACHE questionnaire in the intervention group was higher at discharge (72.8 vs. 67.1, P = 0.04); however, this difference was not sustained. Conclusion Empowering patients with guidelines through an educational intervention resulted in differences in trust in physician and patient satisfaction. Further studies are needed for evaluating a strategy of engaging IBD patients to take a more active role in their care. (clinicaltrials.gov, NCT02569333).

Increasing rates of venous thromboembolism among hospitalised patients with inflammatory bowel disease: a nationwide analysis

“…Other studies have also looked to provide practice guidelines to patients during hospitalisation, but did not show an improvement in the rate of VTE prophylaxis or VTE events as a result of intervention. This, however, may have been due to the small number of patients included in the study, as well as the format in which the information was provided 48 . Further research should assess the effects of educating both patients and providers as to the safety of pharmacologic prophylaxis, as well as the risk of VTE in IBD, in order to decrease future occurrence.…”

“…This, however, may have been due to the small number of patients included in the study, as well as the format in which the information was provided. 48 Further research should assess the effects of educating both patients and providers as to the safety of pharmacologic prophylaxis, as well as the risk of VTE in IBD, in order to decrease future occurrence.…”

Hungarian Linguistic, Cross-Cultural, and Age Adaptation of the Patient Satisfaction with Health Care in Inflammatory Bowel Disease Questionnaire (CACHE) and the Medication Adherence Report Scale (MARS)

“…So far, after validation of the CACHE questionnaire by Casellas et al [ 26 ], the survey has been used in different countries [ 27 , 28 , 29 ], but foreign adaptation has not yet been published. According to our participants, the questionnaire was relatively long, however, all patients answered the questions.…”

“…The MARS questionnaire was validated by Horne et al [ 21 ], in England for chronic diseases and has been adapted in various countries, such as Germany, Sweden and Portugal [ 22 , 23 , 24 , 25 ]. The CACHE questionnaire was validated by Casellas et al [ 26 ], for the adult IBD population in Spain and has not been adapted yet but used in different countries, e.g., Canada, Italy and Spain [ 27 , 28 , 29 ]. Due to the increase in the number of research projects examining a common issue, such as transition, the need to adapt questionnaires for use outside the mother language is also increasing.…”

Adherencia a recomendaciones basadas en evidencia para enfermedades crónicas no transmisibles: estudio de corte transversal multicéntrico en médicos de Bogotá

“…The objective of CPGs, as compiled from evidence-based recommendations, is to improve clinical outcomes, avoid unjustified variability in clinical practice, implement health resources more efficiently, and reduce inequity gaps (9,11). Consistently, greater adherence of users to CPG has improved clinical outcomes and reduced health costs in CNCD patients (12)(13)(14)(15)(16).…”