Perceptions of the public healthcare system from private-care patients with irritable bowel syndrome with constipation in Spain

ABSTRACT

Background: Irritable bowel syndrome (IBS) is associated with reduced health-related quality of life. Patients with IBS benefit from positive patient-provider experiences during treatment. However, many continue to suffer from limited symptom relief and hold negative perceptions. Purpose: to identify potential barriers perceived by patients with IBS with constipation (IBS-C) within the the private health care system compared with the care under the public health-care system in Spain. Methods: this is a multicenter, cross-sectional observational study. Patients with previous experience of public healthcare who attended a private consultation with a gastroenterologist due to constipation/abdominal discomfort, with no previous IBS diagnosis and meeting Rome III criteria at the time of survey completion without alarm symptoms, were invited to join the study. Participants completed the Irritable Bowel Syndrome Patient Experience questionnaire, the Irritable Bowel Syndrome Symptom Severity Score questionnaire and the EuroQol five-dimensions questionnaire, reporting their health-related quality of life. Results: seven hundred and seven patients met the study criteria and were evaluated. With regard to public healthcare, patients reported feeling more positive towards their gastroenterologist (62.8% satisfied) than their primary care physician (43.9% satisfied). Patients reported moderate/severe problems with pain/discomfort (61.5%). The majority of patients were treated with fiber (85.3%), laxatives (79.3%) and antispasmodics (54.3%); 47.0% and 11.7% of patients noted little and no improvement, respectively. Conclusions: the perceptions of patients with irritable bowel syndrome and constipation were more positive towards their gastroenterologist than their primary care physician in the public healthcare sector. However, patients were still dissatisfied with the treatment and care received, highlighting the unmet need for improved patient-provider communication to achieve better outcomes

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