Acceptance of inflammatory bowel disease treatment recommendations based on appropriateness ratings : do practicing gastroenterologists agree with experts?

Details

Serval ID
serval:BIB_8C1791A1B926
Type
Article: article from journal or magazin.
Collection
Publications
Title
Acceptance of inflammatory bowel disease treatment recommendations based on appropriateness ratings : do practicing gastroenterologists agree with experts?
Journal
Journal of Crohn's and Colitis
Author(s)
Pittet V., Maillard M.H., Lauvergeon S., Timmer M., Michetti P., Froehlich F., Burnand B., Vader J.P., Mottet C.
ISSN
1876-4479 (Electronic)
ISSN-L
1873-9946
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
9
Number
2
Pages
132-139
Language
english
Notes
IUMSP2015/02
Abstract
BACKGROUND: Appropriateness criteria for the treatment of Crohn's disease (CD) and ulcerative colitis (UC) have been developed by experts' panels. Little is known about the acceptance of such recommendations by care providers. The aim was to explore how treatment decisions of practicing gastroenterologists differ from experts using a vignette case study and a focus group.
METHODS: Seventeen clinical vignettes were drawn from clinical indications evaluated by the expert panel. A vignette case questionnaire asking for treatment options in 9-10 clinical situations was submitted to 26 practicing gastroenterologists. For each vignette case, practitioners' answers on treatments deemed appropriate were compared to panel decisions. Qualitative analysis was made based on focus group discussion to explore acceptance and divergence reasons.
RESULTS: 239 clinical vignettes were completed, 98 for CD and 141 for UC. Divergence between proposed treatments and results from panels was more frequent for CD (34%) than for UC (27%). Among UC clinical vignettes, the main divergences with the panel were linked to 5-ASA failure assessment and to situations where stopping treatment was the main decision. For CD, the care provider propositions diverged with the panel in mild-to-moderate active disease, where practitioners were more prone to an accelerated step up than the panel's recommendations.
CONCLUSIONS: In about one third of vignettes cases, IBD treatment propositions made by practicing gastroenterologists diverged as compared to expert recommendations. Practicing gastroenterologists may experience difficulties in applying recommendations in daily practice.
Keywords
Keywords: Ulcerative colitis, Crohn's disease, vignette case study, focus groups, appropriateness of care
Pubmed
Web of science
Open Access
Yes
Create date
16/01/2015 12:40
Last modification date
08/05/2019 21:44
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