Quality of Care in Ulcerative Colitis: A Modified Delphi Panel Approach
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Laurent Peyrin-Biroulet1, Daniel C Baumgart2, Alessandro Armuzzi3
1Department Gastroenterology, CHU de Nancy, Vandoeuvre-lès-Nancy, France.
Objectives:
To establish clinical consensus on important and relevant quality-of-care (QoC) attributes in ulcerative colitis (UC) treatment that may improve treatment outcomes and guide best practices.
Methods:
Thirty-eight QoC attributes were identified in a literature review. Sixteen European-based experts were selected based on their contributions to UC guidelines, publications, and patient care. A 3-round, modified Delphi panel was conducted including an interview round, and 2 web-based rounds to reach consensus and finalize a QoC attribute list.
Results:
The draft QoC attribute list derived from a literature review and Round 1, expert interviews, comprised 63 attributes. In Rounds 2 and 3, the QoC attributes frequently rated as critically important were diagnosis (n = 15, 93.8%), treatment adherence (n = 15, 93.8%), and access to care/treatment (Round 2: n = 14, 87.5%; Round 3: n = 15, 93.8%). The final QoC attribute list consisted of 61 attributes across 20 domains, with the most attributes reported in the "treatment goals" domain (n = 9).
Conclusion:
QoC is a complex and evolving concept that can improve outcomes while maximizing healthcare resources. Limited time and resources hamper clinicians' ability to openly and empathetically communicate with patients; novel technology may help to offer solutions.
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