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

doi:10.12998/wjcc.v10.i33.12184

Quality of care in patients with inflammatory bowel disease from a public health center in Brazil

World J Clin Cases. 2022 Nov 26;10(33):12184-12199. doi: 10.12998/wjcc.v10.i33.12184.

Authors

Debora Mayumi Takamune¹, Giovana Signorelli Astolfi Cury¹, Giulia Ferrás¹, Giedre Soares Prates Herrerias¹, Adriana Rivera², Jaqueline Ribeiro Barros¹, Julio Pinheiro Baima^{1

3}, Rogerio Saad-Hossne⁴, Ligia Yukie Sassaki⁵

Affiliations

¹ Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618686, São Paulo, Brazil.
² Research Unit, Virgen Macarena University Hospital, Seville 41009, Spain.
³ Department of Medicine, Nove de Julho University, Bauru 17011-102, São Paulo, Brazil.
⁴ Department of Surgery, São Paulo State University (Unesp), Medical School, Botucatu 18618686, São Paulo, Brazil.
⁵ Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618686, São Paulo, Brazil. ligia.sassaki@unesp.br.

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