Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 14, 2012; 18(18): 2212-2218
Published online May 14, 2012. doi: 10.3748/wjg.v18.i18.2212
Satisfaction with patient-doctor relationships in inflammatory bowel diseases: Examining patient-initiated change of specialist
Daniel R van Langenberg, Jane M Andrews
Daniel R van Langenberg, Jane M Andrews, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, School of Medicine, University of Adelaide, South Australia 5000, Australia
Daniel R van Langenberg, Department of Gastroenterology and Hepatology, Eastern Health Clinical School, Monash University, Victoria 3128, Australia
Author contributions: van Langenberg DR and Andrews JM both contributed equally to this work; both authors designed and performed the research, analysed the data and wrote the paper.
Correspondence to: Jane M Andrews, MBBS, PhD, FRACP, Clinical Associate Professor, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia.
Telephone: +61-8-82224000 Fax: +61-8-82222414
Received: January 20, 2011
Revised: November 11, 2011
Accepted: December 31, 2011
Published online: May 14, 2012

AIM: To assess the reasons for, and factors associated with, patient-initiated changes in treating specialist in inflammatory bowel diseases (IBD).

METHODS: Prospectively identified IBD patients (n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed, including whether they had changed treating specialist and why. Negative reasons included loss of confidence, disagreement, and/or personality clash with the specialist.

RESULTS: Of 162 respondents, 70 (43%) had ever changed specialists; 30/70 (43%) for negative reasons, 52/70 (74%) in the preceding year. Patients with negative reasons for changing (n = 30) were younger (median, 35.2 years vs 45.3 years) ,had higher IBD knowledge (median, 5.0 years vs 4.0 years), yet had lower medication adherence and satisfaction scores (median, 19.0 years vs 22.0 years, 14.0 years vs 16.0 years respectively, Mann-Whitney tests, all P < 0.05), compared to all other responders (n = 132). Patients with a recent change (for any reason) were more likely to have Crohn’s disease, currently active disease, previous bowel resection and recent hospitalization [OR 2.6, 95% CI (1.3-5.4), 2.2 (1.0-4.7), 5.56 (1.92-16.67), 2.0 (1.3-3.0), each P < 0.05].

CONCLUSION: Changing specialist appears associated with patient- related (age, nonadherence) and contemporaneous disease-related factors (recent relapse) which, where modifiable, may enhance patient-doctor relationships and therefore quality of care.

Keywords: Inflammatory bowel disease, Patient-doctor relationship, Quality of care, Disease outcomes, Quality of life