Quality of life following fistulotomy – short term follow‐up

Owen, H A; Buchanan, G. N.; Schizas, Alexis; Emmanuel, Anton; Cohen, Richard; Williams, Andrew B.

doi:10.1111/codi.13538

Cited by 11 publications

(6 citation statements)

References 34 publications

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“…Generic QoL measurement instruments are used in the study of many chronic diseases, such as stroke [ 17 ], diabetes [ 18 ], and heart disease [ 19 ]. In the study of anal fistulae, instruments such as the Short Form-36, Short Form-12 [ 20 , 21 , 22 , 23 ], the Cleveland Global Quality of Life score [ 24 , 25 ], and EQ 5D [ 26 , 27 ] have been used to assess QoL. Although these have the benefit of allowing comparison between diseases, patients with anal fistulae have described how QoL issues are tightly tied into their unique symptom profile [ 4 , 5 ], and so these generic instruments may not be sensitive to subtle changes in symptoms, particularly in response to treatment.…”

Section: Discussionmentioning

confidence: 99%

Do Patient-Reported Quality-of-Life (QoL) Scales Provide an Adequate Assessment of Patients with Cryptoglandular Anal Fistulae? A Systematic Review of Measurement Instruments and Their Content Validity

Iqbal

Shah²,

Alrubaiy³

et al. 2022

Clinics and Practice

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Background: Cryptoglandular anal fistulae can significantly affect patient quality of life (QoL), making it essential to ensure that any study of fistula treatment assesses the impact on QoL. The aim of this systematic review was to evaluate the content validity of Patient-Reported Outcome Measures (PROMs) that assess QoL in patients with a fistula. Methods: MEDLINE, EMBASE, PsycINFO, and Scopus were searched and studies assessing the content validity of patient-reported QoL measurement instruments, or PROM development studies in patients with cryptoglandular anal fistulae, were included. Data were extracted from eligible studies to determine the instruments’ relevance, comprehensiveness, and comprehensibility, and their quality was assessed according to COnsensus-based Standards for the Selection of health Measurement Instruments (COSMIN). Results: Two PROM development studies were identified, both of which described the development of a disease-specific QoL measurement instrument for patients with cryptoglandular anal fistulae. The overall content validity of these instruments was inconsistent and supported by very low-quality evidence. There were no studies assessing the content validity of established QoL measurement instruments in patients with fistulae. Conclusions: This systematic review could not establish the content validity of the available QoL PROMs for patients with anal fistulae, due either to the absence of designated content validity studies or a lack of comprehensiveness of the available PROMs. This highlights an important gap in the literature that needs to be addressed to ensure high-quality outcome assessment in patients with fistulae.

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Section: Discussionmentioning

confidence: 99%

Do Patient-Reported Quality-of-Life (QoL) Scales Provide an Adequate Assessment of Patients with Cryptoglandular Anal Fistulae? A Systematic Review of Measurement Instruments and Their Content Validity

Iqbal

Shah²,

Alrubaiy³

et al. 2022

Clinics and Practice

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show abstract

“…The studies that have been conducted highlight lower QoL in patients with fistula than in the general population and demonstrate an improvement following successful fistulotomy. [52][53][54] Despite this, few studies of fistula treatments recognise the value of QoL as an outcome, and work is underway to develop disease-specific instruments to be able to facilitate QoL measurement in clinical practice and uptake into trials assessing treatment efficacy.…”

Section: Complex Cryptoglandular Sepsismentioning

confidence: 99%

Managing non-IBD fistulising disease

Sahnan

Adegbola

Iqbal

et al. 2020

Frontline Gastroenterol

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“…Patients typically experience perianal pain and ongoing discharge from the external opening, in addition to infective episodes and the development of recurrent abscesses requiring surgical drainage. These symptoms drive a significant QoL burden and require considerable practical adjustments [4][5][6][7]. When asked about the most important QoL issues associated with fistula treatment, patients were more likely to prioritise factors relating to psycho-social wellbeing [8].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, surgeons and most of the known literature focussed primarily on the impact of physical symptoms [ 8 ]. Surgical treatment as been demonstrated to improve QoL [ 6 ], even in patients who see a minor deterioration in continence as a result [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Living with cryptoglandular anal fistula: a qualitative investigation of the patient's experience through semi-structured patient interviews

et al. 2022

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Purpose Cryptoglandular anal fistula continues to be a subject of extensive surgical research due to the lack of effective and enduring treatments, some of which incur risks to continence and quality of life. However, the patient experience of disease has seldom been reported. The aims of this study are to understand the impact of living with a fistula and the treatment outcomes that are valued by patients. Methods Patients with cryptoglandular anal fistula were recruited using purposive sampling from two tertiary referral centres in the UK and the Netherlands. Patients underwent semi-structured interviews that were audio-recorded and transcribed verbatim. Dutch transcripts were translated into English and underwent independent, thematic analysis using open coding by two study team members to identify common themes and sub-themes. Results Twenty interviews were conducted before saturation was reached (11 male, median age 49, Interquartile range 39–55 years). Four broad themes emerged, covering the physical symptoms of fistula, the patient journey towards understanding the condition, life impact, and treatment. Several inter-related sub-themes were found, reflecting the extensive impact and adjustment that the disease entails. Conclusion The impact of cryptoglandular anal fistula extends beyond the physical symptoms of pain and discharge, requires significant readjustment, and often negatively impacts psycho-social wellbeing. These aspects of disease should receive greater attention in future assessment of treatment and quality of life.

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Quality of life following fistulotomy – short term follow‐up

Abstract: QOL significantly improved at 3 months' follow-up after fistulotomy where continence was maintained or a small reduction occurred.

Cited by 11 publications

References 34 publications

Do Patient-Reported Quality-of-Life (QoL) Scales Provide an Adequate Assessment of Patients with Cryptoglandular Anal Fistulae? A Systematic Review of Measurement Instruments and Their Content Validity

Do Patient-Reported Quality-of-Life (QoL) Scales Provide an Adequate Assessment of Patients with Cryptoglandular Anal Fistulae? A Systematic Review of Measurement Instruments and Their Content Validity

Managing non-IBD fistulising disease

Living with cryptoglandular anal fistula: a qualitative investigation of the patient's experience through semi-structured patient interviews

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