Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12184-12199
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12184
Quality of care in patients with inflammatory bowel disease from a public health center in Brazil
Debora Mayumi Takamune, Giovana Signorelli Astolfi Cury, Giulia Ferrás, Giedre Soares Prates Herrerias, Adriana Rivera, Jaqueline Ribeiro Barros, Julio Pinheiro Baima, Rogerio Saad-Hossne, Ligia Yukie Sassaki
Debora Mayumi Takamune, Giovana Signorelli Astolfi Cury, Giulia Ferrás, Giedre Soares Prates Herrerias, Jaqueline Ribeiro Barros, Julio Pinheiro Baima, Ligia Yukie Sassaki, Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618686, São Paulo, Brazil
Adriana Rivera, Research Unit, Virgen Macarena University Hospital, Seville 41009, Spain
Julio Pinheiro Baima, Department of Medicine, Nove de Julho University, Bauru 17011-102, São Paulo, Brazil
Rogerio Saad-Hossne, Department of Surgery, São Paulo State University (Unesp), Medical School, Botucatu 18618686, São Paulo, Brazil
Author contributions: Takamune DM, Cury GSA, Ferrás G, Herrerias GSP, Rivera A, Barros JR, Baima JP, Saad-Hossne R, and Sassaki LY contributed to the conception and design of the study, the acquisition, analysis and interpretation of data, drafting the article, and revising it critically for important intellectual content and approving the final version to be submitted; Rivera A had substantial contributions to interpretation of data, revising it critically for important intellectual content and final approval of the version.
Supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES), No. code 001; and São Paulo Research Foundation (FAPESP), No. 2018/05571-0 and No. 2018/05705-6.
Institutional review board statement: The study was approved by the Local Research Ethics Committee (Approval No. CAAE: 85661018.0.0000.5411).
Informed consent statement: All participants received explanations about the study objectives and expected results, having been enrolled in the study only after signing the informed consent form.
Conflict-of-interest statement: The authors have no conflicts of interests to declare regarding the present work.
Data sharing statement: The datasets, including the redacted study protocol, redacted statistical analysis plan, and individual participants’ data supporting the results reported in this article, will be made available within three months from initial request to researchers who provide a methodologically sound proposal. The data will be provided after its de-identification, in compliance with applicable privacy laws, data protection and requirements for consent and anonymization.
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: Ligia Yukie Sassaki, MD, PhD, Assistant Professor, Full Professor, Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Rubião Junior, Botucatu 18618686, São Paulo, Brazil. ligia.sassaki@unesp.br
Received: July 20, 2022
Peer-review started: July 20, 2022
First decision: September 25, 2022
Revised: October 14, 2022
Accepted: October 24, 2022
Article in press: October 24, 2022
Published online: November 26, 2022
Processing time: 126 Days and 9.4 Hours
Abstract
BACKGROUND

Inflammatory bowel diseases (IBDs) are chronic diseases that demand continuous interaction between patients and healthcare providers. Quality of care (QoC) is a factor that contributes to a patient’s adherence to treatment and its success.

AIM

To evaluate QoC in patients from a single IBD reference center.

METHODS

This cross-sectional study included 133 patients from a single Brazilian IBD public health center. QoC was evaluated through the QoC Through the Eyes of Patients with IBD (QUOTE-IBD) questionnaire (based on patient perspectives), which measures eight dimensions of care. We compared QoC among patients with Crohn’s disease and ulcerative colitis and analyzed the clinical and psychological factors associated with QoC satisfaction. Clinical evaluations assessed disease characteristics, quality of life, anxiety, and depression levels.

RESULTS

Sixty-nine patients with Crohn’s disease and 64 with ulcerative colitis were interviewed. The mean age was 37.26 years ± 13.05 years, and 63.91% of the patients were women. The mean duration of the disease was 8.44 years ± 7.59 years, where most patients were in remission (70.31% of patients with ulcerative colitis and 62.32% with Crohn’s disease). The total QoC score of the sample was 8.61 years ± 1.31 points, indicating that the QoC provided by the center was unsatisfactory. According to univariate logistic regression, patients with Crohn’s disease had higher satisfaction rates than those with ulcerative colitis [odds ratio (OR): 2.746; 95% confidence interval (CI): 1.360-5.541; P = 0.0048] and patients on infliximab (OR: 2.175; 95%CI: 1.037-4.562; P = 0.0398).

CONCLUSION

Patients from the IBD public center reported good doctor-patient relationships, but had problems related to the healthcare structure. Evaluation of healthcare centers is of paramount to improve QoC for the patients involved.

Keywords: QUOTE-IBD questionnaire; Quality of care; Crohn’s disease; Ulcerative colitis; Inflammatory bowel disease; Doctor-patient relationship

Core Tip: Inflammatory bowel disease (IBD) is an immune-mediated disease that requires a close relationship between the patient and their healthcare service provider. Quality of care (QoC) is a crucial factor for the success of IBD treatment. The present study evaluated QoC in a public center in Brazil. The center was well-evaluated, showing good doctor-patient relationship but had problems especially those relating to the structure of healthcare practices. Evaluation of healthcare centers is of paramount importance, encouraging improvements that provide better care, disease control, and quality of life for the patients involved.