Opinion Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2023; 29(6): 917-925
Published online Feb 14, 2023. doi: 10.3748/wjg.v29.i6.917
Medical consultation in ulcerative colitis: Key elements for improvement
Yago González-Lama, Elena Ricart, Ana Cábez, Pilar Fortes, Susana Gómez, Francesc Casellas
Yago González-Lama, Inflammatory Bowel Disease Unit, Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid 28222, Spain
Elena Ricart, Inflammatory Bowel Disease Unit, Department of Gastroenterology, Hospital Clínic, Barcelona 08036, Spain
Elena Ricart, Francesc Casellas, Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBERehd), Barcelona 08036, Spain
Ana Cábez, Pilar Fortes, Department of Medical, Pfizer Spain, Madrid 28108, Spain
Susana Gómez, Servicio de Reumatología, Hospital Universitario de Salamanca, Salamanca 37007, Spain
Francesc Casellas, Department of Gastroenterology, Vall d'Hebron Research Institute, Barcelona 08035, Spain
Author contributions: González-Lama Y, Ricart E, Cábez A, Fortes P, Gómez S, and Casellas F conceived the idea for the manuscript, reviewed the literature and drafted the manuscript.
Conflict-of-interest statement: Fortes P and Cábez A are employees of Pfizer (Spain). González-Lama Y, Casellas F, and Ricart E have received consultancy fees from Pfizer S.L.U. for their work in this project but have no other relevant financial relationships to disclose. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in this manuscript apart from those disclosed. González-Lama Y received research funding from AbbVie, Ferring, MSD, Takeda, Janssen, and Pfizer; speaker fees from AbbVie, Ferring, Gebro, Takeda, and Janssen. Casellas F received research funding from AbbVie, Ferring, MSD, Shire, Takeda, Zambon and Pfizer; speaker fees from AbbVie, Chiesi, Ferring, Gebro, MSD, Shire, Takeda, and Zambon.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francesc Casellas, MD, Doctor, Department of Gastroenterology, Vall d'Hebron Research Institute, Pg Vall d'Hebron 119-129, Barcelona 08035, Spain. fcasellas@vhebron.net
Received: October 20, 2022
Peer-review started: October 20, 2022
First decision: November 5, 2022
Revised: November 18, 2022
Accepted: January 20, 2023
Article in press: January 20, 2023
Published online: February 14, 2023
Processing time: 112 Days and 23.9 Hours
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.