Determinants of Patient Response to Satisfactory Relief in Patients with Irritable Bowel Syndrome
Public Deposited- Last Modified
- January 6, 2020
- Creator
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Bhatt, Skand D.
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- BACKGROUND: Treatment trials for Irritable Bowel Syndrome (IBS) commonly report satisfactory relief of symptoms as an outcome measure at the end of a trial. It is unclear what predicts a response to this multidimensional construct. AIMS: (1) Assess if the following primary independent variables predict satisfactory relief of bowel symptoms: patient reported effectiveness of treatment, patient report severity of side effects, and patient satisfaction with initial physician visit. (2) Determine if these independent variables differ among patients taking prescription versus non-prescription medications for IBS relief. (3) Determine if satisfactory relief is predicted by baseline scores on the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SS) or the Brief Symptom Inventory (BSI). ( 4) Test if the independent variables predict satisfaction with treatment. METHODS: A total of 835 patients (78% females, average age 52 yr) who had a medical diagnosis of iBS and satisfied Rome II criteria, were recruited from Group Health Cooperative of Puget Sound. The initial questionnaire assessed baseline symptom severity (IBS-SS) and psychological distress (BSI). The follow-up questionnaire, administered after 6 months, assessed responses to the satisfactory relief outcome measured on a binary scale, satisfaction with treatment outcome measured on an ordinal scale, and responses to patient reported effectiveness of treatment, patient report severity of side effects, and patient satisfaction with initial physician visit. RESULTS: Greater patient reported treatment effectiveness predicted satisfactory relief for prescription drug users (OR= 3.1) and nonprescription drug users (OR= 2.3). Lesser side effect severity to prescription drugs was a statistically significant predictor of satisfactory relief for prescription drugs (OR= 0.65) but not nonprescription drugs. Patient satisfaction with initial physician visit had a negligible predictive value for the satisfactory relief outcome after adjusting for other independent variables. Responses to the secondary outcome, satisfaction with treatment measured on an ordinal scale, were largely congruent with satisfactory relief for all primary variables tested. Neither baseline psychological distress nor baseline symptom severity significantly predicted satisfactory relief after multivariable adjustment, although the results suggest that a larger sample may show significant trends. CONCLUSIONS: These data from an observational study suggest that patient's perceptions of drug effectiveness and side effect severity with prescription medications are significant predictors of satisfactory relief, while physician-patient interaction does not significantly predict satisfactory relief. These results may help in the future design of clinical trials for IBS.
- Date of publication
- May 2007
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Paper type: Research or research design
- Track: HC&P
- Advisor
- Whitehead, William
- Reviewer
- Harris, Russell
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2007
- Language
- Deposit record
- 564d1737-ca9b-4211-9c3e-c1926665c3df
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