Assessing patient satisfaction in inflammatory bowel disease using the QUOTE-IBD survey: a small step for clinicians, a potentially large step for improving quality of care.

BACKGROUND

Patient satisfaction is thought integral to high quality of care (QoC) in chronic disease models, including inflammatory bowel disease (IBD). Here we utilized the QUOTE-IBD survey in IBD clinic patients, in order to examine potential deficiencies in QoC from the patients' perspective, thus possibly amenable to change.

METHODS

Consecutive patients attending a single clinic were asked to complete the QUOTE-IBD survey, where 22 items (in seven domains) were rated for importance (I), and actual performance (P), and a quality index (QI) was derived. A QI <9.0 indicated suboptimal satisfaction. Other data were extracted from hospital records and CRP was measured. Factorial ANOVA examined effects of relevant clinical and demographic factors on satisfaction (QI) scores per domain.

RESULTS

Of 367 potential participants, 187 (51%) responded. 86 (46%) had Crohn's disease, 101 (54%) ulcerative colitis; 52% were females, and median age was 45y (range 18,82). The only QI score <9.0 was 'kept in waiting room >15min' (QI 8.73). In bivariate analyses, those with Crohn's, post-resection and longer IBD duration each had lower domain QI's than their respective counterparts, whereas those on concurrent anti-TNF therapy gave higher QI scores (each p<0.05). Factorial ANOVA showed female gender and IBD duration ≥ 5years were each associated with significantly lower mean QI scores in multiple domains.

CONCLUSIONS

Patients with adverse disease characteristics (e.g. longer duration, post-resection) and females reported lower satisfaction. Conversely, those on anti-TNF therapy reported higher satisfaction. Targeting these 'at-risk' groups and assessing satisfaction longitudinally may enhance QoC in IBD.