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New research suggests a need for education among some health care specialists about the clinical presentation of ulcerative colitis (UC), particularly primary care physicians (PCPs), family medicine physicians (FPs), and internal medicine (IM).

Findings from the health care provider survey were presented at the 2024 Crohn’s & Colitis Congress, January 25-27, 2024, in Las Vegas, NV.

For patients with UC, treatment decisions depend on disease severity, according to researchers. “This observational, cross-sectional, web-based survey sought to provide insight into the real-world symptoms and clinical characteristics that factor into healthcare providers’ (HCPs) treatment choices for their patients with UC in the United States,” added presenting author Marla Dubinksy, MD, pediatric gastroenterologist, Icahn School of Medicine, Mount Sinai, New York, and colleagues in the abstract.

Dubinksy and colleagues examined self-reported data collected from HCPs using a standard online questionnaire between November 21, 2022, and December 6, 2022. HCPs were eligible for inclusion if they treated at least 10 adults with UC each month, worked more than 20 hours per week in direct patient care, and finished the survey in English.

Study participants were gastroenterologists (GIs), PCPs, IMs, FPs, nurse practitioners (NPs) and physician assistants (PAs), according to the abstract.

“Questionnaire responses were summarized through descriptive statistics, and post hoc comparisons between HCP types (GIs, FM/IM/PCPs, PAs, NPs) were performed using binomial regression models without adjustment for multiple comparisons,” noted investigators.

FINDINGS

A total of 459 HCPs (47.9% men; 55.1% aged 30-49 years) were included in the study, of which 55.3% were physicians, 22.7% were NPs, and 22.0% were PAs. Approximately 50% of the HCPs described their primary medical specialty as primary care/family care, followed by 37.7% in gastroenterology and 12.9% in IM, according to researchers.

Participants were asked to choose 3 UC symptoms from a list of 13 they considered most important in deciding treatment options. The majority of HCPs selected rectal bleeding (60%), followed by cramping or other abdominal pain (45%), diarrhea (41%), anemia (34%), and bowel urgency (28%). Investigators observed that the proportions were similar across specialties, except a greater proportion of GIs (60%) selected diarrhea than the other specialties (NPs: 42%, P = .0127; FM/IM/PCPs: 33%, P < .0001).

The following symptoms were rated as “very important” or “extremely important” by participants for deciding treatment options:

• Rectal bleeding (87.4%)
• Clinical remission (86.7%)
• Abdominal pain (81.4%)
• Stool frequency (77.6%)
• Bowel urgency (77.3%)
• Mucosal appearance (72.9%)
• Histologic appearance (71.5%)

In addition, investigators found a higher percentage of GIs, PAs, and NPs rated several UC symptoms as “very important” or “extremely important” more frequently than FMs, IMs, and PCPs, including bowel urgency (GIs: P < .0001); PAs: P = .0182; NPs: P =. 0342), mucosal appearance (P < .001, P = .0091; P = .0009), and stool frequency ( P= .0013; P = .0283; P = .0114).

“Results suggest a need for education among some specialties, particularly FMs, IMs, and PCPs, about the clinical presentation of UC and most important symptoms to consider when deciding treatment options for patients with UC,” concluded Dubinksy et al.

Source: Dubinksy M, Hunter T, Sweeney C, et al. Real-world experience and perspectives on the treatment of ulcerative colitis: Results from a healthcare provider survey. Abstract presented at: 2024 Crohn’s & Colitis Congress; January 25-27, 2024; Las Vegas, NV. Accessed January 25, 2024.