Patients’ and gastroenterologists’ preferences regarding outcomes and medication attributes in ulcerative colitis

Anastasia Katsoula; Olga Giouleme; Paschalis Paschos; Maria Toumpalidou; Maria Mainou; Konstantinos Malandris; Anna-Bettina Haidich; Apostolos Tsapas

Authors Anastasia Katsoula, Olga Giouleme, Paschalis Paschos, Maria Toumpalidou, Maria Mainou, Konstantinos Malandris, Anna-Bettina Haidich, Apostolos Tsapas.

Abstract

Background Patients’ and gastroenterologists’ views on the relative importance of treatment outcomes and medication attributes for ulcerative colitis (UC) may differ. We aimed to explore which treatment outcomes and medication attributes are considered important by both for therapeutic decisions.

Methods Eight gastroenterologists and 23 patients with UC in Greece participated in semistructured interviews and focus groups, respectively. The focus groups and interviews were audiorecorded, transcribed and coded, utilizing thematic analysis until data saturation was achieved.

Results Themes that were discussed included the impact of UC on daily life, UC-related outcomes, drug-related attributes and the patient–doctor relationship. Within these themes, disparities between the perspectives of gastroenterologists and patients were evident on 2 main issues. Gastroenterologists prioritized clinical remission and emphasized long-term objectives, such as mucosal healing, while patients focused on shorter-term outcomes, such as the early and sustained relief of symptoms. Regarding medication attributes, important factors for patients were primarily those that impacted their daily life, such as route of administration, dosage and the need for hospital visits. In contrast, gastroenterologists were more concerned about potential adverse events and non-responsiveness to treatment. There was a consensus regarding the importance of shared decision-making for UC management, emphasized by both patients and clinicians.

Conclusions Gastroenterologists mostly prioritize objective measures of remission, while patients mainly focus on factors related to their quality of life and overall well-being. Enhancing communication regarding different goals and expectations may strengthen the physician–patient relationship, ultimately resulting in better shared therapeutic decision-making.

Keywords Ulcerative colitis, qualitative research, patient-centered approach

Ann Gastroenterol 2025; 38 (2): 174-181