Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines.
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.
Jones
Roger
R
Department of General Practice and Primary Care, King's College London. roger.jones@kcl.ac.uk
Hunt
Claire
C
Stevens
Richard
R
Dalrymple
Jamie
J
Driscoll
Richard
R
Sleet
Sarah
S
Blanchard Smith
Jonathan
J
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