Predictors of Healthcare-seeking Behavior Among Chinese Patients with Irritable Bowel Syndrome

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2017 Dec 6

PMID 29204063

Citations 9

Authors

Wen-Juan Fan

Dong Xu

Min Chang

Li-Ming Zhu

Gui-Jun Fei

Xiao-Qing Li

Xiu-Cai Fang

Affiliations

Soon will be listed here.

Abstract

Aim: To analyze predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome (IBS) and their satisfaction with medical care.

Methods: Participating patients met IBS Rome III criteria (excluding those with organic diseases) and were enrolled in an IBS database in a tertiary university hospital. Participants completed IBS questionnaires in face-to-face interviews. The questionnaires covered intestinal and extra-intestinal symptoms, medical consultations, colonoscopy, medications, and self-reported response to medications during the whole disease course and in the past year. Univariate associations and multivariate logistic regression were used to identify predictors for frequent healthcare-seeking behavior (≥ 3 times/year), frequent colonoscopies (≥ 2 times/year), long-term medications, and poor satisfaction with medical care.

Results: In total, 516 patients (293 males, 223 females) were included. Participants' average age was 43.2 ± 11.8 years. Before study enrollment, 55.2% had received medical consultations for IBS symptoms. Ordinary abdominal pain/discomfort (non-defecation) was an independent predictor for healthcare-seeking behavior (OR = 2.07, 95%CI: 1.31-3.27). Frequent colonoscopies were reported by 14.7% of patients (3.1 ± 1.4 times per year). Sensation of incomplete evacuation was an independent predictor for frequent colonoscopies (OR = 2.76, 95%CI: 1.35-5.67). During the whole disease course, 89% of patients took medications for IBS symptoms, and 14.7% reported they were satisfied with medical care. Patients with anxiety were more likely to report dissatisfaction with medical care (OR = 2.08, 95%CI: 1.20-3.59). In the past year, patients with severe (OR = 1.74, 95%CI: 1.06-2.82) and persistent (OR = 1.66, 95%CI: 1.01-2.72) IBS symptoms sought medical care more frequently.

Conclusion: Chinese patients with IBS present high rates of frequent healthcare-seeking behavior, colonoscopies, and medications, and low satisfaction with medical care. Intestinal symptoms are major predictors for healthcare-seeking behavior.

Citing Articles

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References

Zhu L, Huang D, Shi L, Liang L, Xu T, Chang M . Intestinal symptoms and psychological factors jointly affect quality of life of patients with irritable bowel syndrome with diarrhea. Health Qual Life Outcomes. 2015; 13:49. PMC: 4414422. DOI: 10.1186/s12955-015-0243-3. View

Kwan A, Hu W, Chan Y, Yeung Y, Lai T, Yuen H . Prevalence of irritable bowel syndrome in Hong Kong. J Gastroenterol Hepatol. 2002; 17(11):1180-6. DOI: 10.1046/j.1440-1746.2002.02871.x. View

Chey W, Nojkov B, Rubenstein J, Dobhan R, Greenson J, Cash B . The yield of colonoscopy in patients with non-constipated irritable bowel syndrome: results from a prospective, controlled US trial. Am J Gastroenterol. 2010; 105(4):859-65. PMC: 2887227. DOI: 10.1038/ajg.2010.55. View

Chen W, Zheng R, Zeng H, Zhang S . The incidence and mortality of major cancers in China, 2012. Chin J Cancer. 2016; 35(1):73. PMC: 4971631. DOI: 10.1186/s40880-016-0137-8. View

Xiong L, Chen M, Chen H, Xu A, Wang W, Hu P . [A population-based epidemiologic study of irritable bowel syndrome in Guangdong province]. Zhonghua Yi Xue Za Zhi. 2004; 84(4):278-81. View

Lu C, Chen C, Lang H, Luo J, Wang S, Chang F . Current patterns of irritable bowel syndrome in Taiwan: the Rome II questionnaire on a Chinese population. Aliment Pharmacol Ther. 2003; 18(11-12):1159-69. DOI: 10.1046/j.1365-2036.2003.01711.x. View

Dapoigny M, Bellanger J, Bonaz B, Bruley des Varannes S, Bueno L, Coffin B . Irritable bowel syndrome in France: a common, debilitating and costly disorder. Eur J Gastroenterol Hepatol. 2004; 16(10):995-1001. DOI: 10.1097/00042737-200410000-00008. View

Akhtar A, Shaheen M, Zha J . Organic colonic lesions in patients with irritable bowel syndrome (IBS). Med Sci Monit. 2006; 12(9):CR363-7. View

Talley N, Boyce P, Jones M . Predictors of health care seeking for irritable bowel syndrome: a population based study. Gut. 1998; 41(3):394-8. PMC: 1891476. DOI: 10.1136/gut.41.3.394. View

10.

Brandt L, Chey W, Foxx-Orenstein A, Schiller L, Schoenfeld P, Spiegel B . An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol. 2009; 104 Suppl 1:S1-35. DOI: 10.1038/ajg.2008.122. View

11.

Drossman D . Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016; . DOI: 10.1053/j.gastro.2016.02.032. View

12.

Hulisz D . The burden of illness of irritable bowel syndrome: current challenges and hope for the future. J Manag Care Pharm. 2004; 10(4):299-309. PMC: 10437478. DOI: 10.18553/jmcp.2004.10.4.299. View

13.

Hungin A, Mulligan C, Pot B, Whorwell P, Agreus L, Fracasso P . Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice -- an evidence-based international guide. Aliment Pharmacol Ther. 2013; 38(8):864-86. PMC: 3925990. DOI: 10.1111/apt.12460. View

14.

Koloski N, Talley N, Boyce P . Predictors of health care seeking for irritable bowel syndrome and nonulcer dyspepsia: a critical review of the literature on symptom and psychosocial factors. Am J Gastroenterol. 2001; 96(5):1340-9. DOI: 10.1111/j.1572-0241.2001.03789.x. View

15.

Koloski N, Talley N, Huskic S, Boyce P . Predictors of conventional and alternative health care seeking for irritable bowel syndrome and functional dyspepsia. Aliment Pharmacol Ther. 2003; 17(6):841-51. DOI: 10.1046/j.1365-2036.2003.01498.x. View

16.

Everhart J, Ruhl C . Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology. 2009; 136(3):741-54. DOI: 10.1053/j.gastro.2009.01.015. View

17.

Lovell R, Ford A . Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012; 10(7):712-721.e4. DOI: 10.1016/j.cgh.2012.02.029. View

18.

Bilbao-Garay J, Barba R, Losa-Garcia J, Martin H, Garcia de Casasola G, Castilla V . Assessing clinical probability of organic disease in patients with involuntary weight loss: a simple score. Eur J Intern Med. 2002; 13(4):240-245. DOI: 10.1016/s0953-6205(02)00032-8. View

19.

Wilson S, Roberts L, Roalfe A, Bridge P, Singh S . Prevalence of irritable bowel syndrome: a community survey. Br J Gen Pract. 2004; 54(504):495-502. PMC: 1324800. View

20.

Faresjo A, Grodzinsky E, Hallert C, Timpka T . Patients with irritable bowel syndrome are more burdened by co-morbidity and worry about serious diseases than healthy controls--eight years follow-up of IBS patients in primary care. BMC Public Health. 2013; 13:832. PMC: 3847157. DOI: 10.1186/1471-2458-13-832. View