title: Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines.
abstract: BACKGROUND
  Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management.
  
  
  OBJECTIVE
  To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome.
  
  
  METHODS
  Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition.
  
  
  METHODS
  Community-based practice in England, UK.
  
  
  METHODS
  Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines.
  
  
  RESULTS
  A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease.
  
  
  CONCLUSIONS
  This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions.
authors.affiliation: Department of General Practice and Primary Care, King's College London. roger.jones@kcl.ac.uk
authors.forename: Roger
authors.initials: R
authors.lastname: Jones
authors.forename: Claire
authors.initials: C
authors.lastname: Hunt
authors.forename: Richard
authors.initials: R
authors.lastname: Stevens
authors.forename: Jamie
authors.initials: J
authors.lastname: Dalrymple
authors.forename: Richard
authors.initials: R
authors.lastname: Driscoll
authors.forename: Sarah
authors.initials: S
authors.lastname: Sleet
authors.forename: Jonathan
authors.initials: J
authors.lastname: Blanchard Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005194:Family Practice; D005260:Female; D017144:Focus Groups; D005767:Gastrointestinal Diseases / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D036301:Qualitative Research; D011787:Quality of Health Care; D055815:Young Adult