Medical consultation in ulcerative colitis: Key elements for improvement

Abstract

Ulcerative colitis (UC) is a chronic inflammatory disease with a high impact. In order to improve patient outcomes, the clinician-patient relationship in daily practice is critical. Clinical guidelines provide a framework for UC diagnosis and treatment. However, standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined. Moreover, UC is a complex disease, given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease. In this article, we have discussed the key elements and specific objectives to consider in medical consultation, such as diagnosis, first visits, follow-up visits, active disease patients, patients on topical therapies, new treatment initiation, refractory patients, extra-intestinal manifestations, as well as challenging situations. The key elements have been mentioned to comprise effective communication techniques, motivational interviewing (MI), as well as information and educational aspects, or organizational issues. The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations, in addition to honesty and empathy with patients, as well as effective communication techniques, MI, information and educational points, or organizational issues. The role of other healthcare professionals such as specialized nurses, psychologists, or the use of checklists was also discussed and commented on.

Keywords: Ulcerative colitis; Patient experience; Shared decision making; Medical consultation; Motivational interviewing; Patient education

Core Tip: Nowadays, patient-centered medical care has become accepted as a preferred care model, especially concerning chronic and heterogeneous diseases like ulcerative colitis. Clearly, medical consultations can substantially be improved by defining objectives along with the patients and adapting decisions and actions to this specific context. This comprises disease clinical features and stage, such as diagnosis, flare, and others, disease impact and patient's needs, as well as patient’s opinions and preferences. Moreover, improvement can be obtained if we put into practice different resources that have demonstrated their efficacy in improving patient care such as effective communication techniques, motivational interviewing, or the use of checklists.