Validation of the Treatment Satisfaction Questionnaire for Crohn?s Disease (TSQ-C)

Abstract

Treatment satisfaction is used to capture the full impact of disease on patients' lives. Currently, no instruments exist to evaluate satisfaction with pharmacologic therapy in patients with Crohn's disease (CD). The purpose of this study was to evaluate the psychometric properties of a treatment satisfaction questionnaire for CD (TSQ-C). The 36-item questionnaire was completed by CD patients who reported taking 5-aminosalicylic acid derivatives to treat their CD. Measures used in the validation study were the Inflammatory Bowel Disease Questionnaire (IBDQ), Crohn's Work Activity Impairment Index (CWAII), and patient reports of clinical indicators (e.g., number of active flares and medications taken). Exploratory factor analysis was used to evaluate the items and subscale structure. Internal consistency reliability and concurrent and discriminant validity were assessed using Cronbach's alpha, Pearson correlation coefficients, and analysis of variance. A total of 813 CD patients participated, with the majority being Caucasian (95.9%), female (67.0%), and >34 years old (86.1%). Patient-rated severity of CD was mild (49.3%), moderate (41.7%), and severe (7.5%). The final TSQ-C consisted of 32 items, with six subscales (Symptoms, Satisfaction, Expectations, Physician Relationships, Bother, and Cost), with each subscale score ranging from 1 to 6. Cronbach's alpha values ranged from 0.63 (Cost) to 0.94 (Symptoms). Strong correlations were observed among the IBDQ, CWAII, and the Satisfaction and Symptoms subscales of the TSQ-C. TSQ-C subscales, particularly Symptoms and Satisfaction, significantly discriminated among levels of number of flares per year, patient-rated disease severity, and number of medication classes. The TSQ-C demonstrated excellent validity and reliability and appears to be a useful tool for evaluating satisfaction with pharmacologic therapy among patients with CD.

Development of an Online Library of Patient-Reported Outcome Measures in Gastroenterology: The GI-PRO Database

“…A higher number of publications per PRO were associated with higher quality as subsequent publications assessed quantitative aspects such as longitudinal assessments and minimally important differences. The PROs cover a range of conditions, including achalasia (23), celiac sprue (24,25), dyspepsia (26–43), eosinophilic esophagitis (44), fecal incontinence (45–60), functional GI disorders (25,41,49,53,60–86), gastroesophageal reflux disease (30,38–40,43,87–110), GI malignancies (48,77,111–115), postgastrectomy (113,116), ileal conduit diversion (117), ileostomy (118), inflammatory bowel disease (119–127), pregnancy-related GI symptoms (128–130), systemic sclerosis (131–133), and radiation enteritis (57), among others. In all, 15 PROs apply to the pediatric population (44,45,60,77,80,97,100,102,115,123,124,134–137), and 6 apply specifically to women (56,128–130,138,139).…”

Assessing patients’ satisfaction with anti-TNFα treatment in Crohn’s disease: qualitative steps of the development of a new questionnaire

“…Four questionnaires assessing patient satisfaction with CD treatments or with anti-TNFα treatments were retrieved from the literature review: 1) a questionnaire developed by Chilton and Collett in 2008, assessing preferences of patients with rheumatoid arthritis (RA) with 3 treatment options;26 2) the Self-Injection Assessment Questionnaire (SIAQ), developed in 2007, assessing the perceived advantages of self-injection and potential limitations of self-injection in RA and CD;27 3) a specific questionnaire developed by Kivitz et al in 2006, assessing preference of patients with RA between 2 treatment devices;28 and 4) the TSQ-C developed in 2005, assessing the satisfaction with pharmacological therapy in patients with mild to moderate CD 29. However, none of them aimed at evaluating specifically patients’ satisfaction with anti-TNFα treatments in CD.…”

“…Those questionnaires used in the field of CD either do not evaluate satisfaction with anti-TNFα treatments specifically and are not designed to be used with severe CD condition, such as the Treatment Satisfaction Questionnaire for Crohn’s disease (TSQ-C);29 or are specific to CD treatments but assess HRQL rather than patients’ satisfaction, such as the Inflammatory Bowel Disease Questionnaire and the Rating Form of Inflammatory Bowel Disease Patient Concerns 12,22. Other available instruments such as the Treatment Satisfaction Questionnaire for Medication (TSQM) and the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) are generic satisfaction questionnaires 23…”

Assessing overall patient satisfaction in inflammatory bowel disease using structural equation modeling

“…The treatment satisfaction questionnaire for CD [34], for example, aims to measure the degree of patient satisfaction with pharmacologic therapy in patients with CD. However, the QUOTE-IBD questionnaire aims to measure the quality of care 'through the eyes of patients with IBD' [35].…”