Predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome

• Published in: World journal of gastroenterology : WJG 2017-11, Vol.23 (42), p.7635-7643
• Main Authors: Fan, Wen-Juan, Xu, Dong, Chang, Min, Zhu, Li-Ming, Fei, Gui-Jun, Li, Xiao-Qing, Fang, Xiu-Cai
• Format: Article
• Language: English
• Subjects: Observational Study
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v23.i42.7635

AIM To analyze predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome(IBS) and their satisfaction with medical care.METHODS Participating patients met IBS Rome Ⅲ criteria(excluding those with organic diseases) and were enrolled in an IBS database in a tertiary university hospital. Participants completed IBS questionnaires in face-to-face interviews. The questionnaires covered intestinal and extra-intestinal symptoms, medical consultations, colonoscopy,medications, and self-reported response to medications during the whole disease course and in the past year. Univariate associations and multivariate logistic regression were used to identify predictors for frequent healthcareseeking behavior(≥ 3 times/year), frequent colonoscopies(≥ 2 times/year), long-term medications, and poor satisfaction with medical care.RESULTS In total, 516 patients(293 males, 223 females) were included. Participants’ average age was 43.2 ± 11.8 years. Before study enrollment, 55.2% had received medical consultations for IBS symptoms. Ordinary abdominal pain/discomfort(non-defecation) was an independent predictor for healthcare-seeking behavior(OR = 2.07, 95%CI: 1.31-3.27). Frequent colonoscopies were reported by 14.7% of patients(3.1 ± 1.4 times per year). Sensation of incomplete evacuation was an independent predictor for frequent colonoscopies(OR = 2.76, 95%CI: 1.35-5.67). During the whole disease course, 89% of patients took medications for IBS symptoms, and 14.7% reported they were satisfied with medical care. Patients with anxiety were more likely to report dissatisfaction with medical care(OR = 2.08, 95%CI: 1.20-3.59). In the past year, patients with severe(OR = 1.74, 95%CI: 1.06-2.82) and persistent(OR = 1.66, 95%CI: 1.01-2.72) IBS symptoms sought medical care more frequently.CONCLUSION Chinese patients with IBS present high rates of frequent healthcare-seeking behavior, colonoscopies, and medications, and low satisfaction with medical care. Intestinal symptoms are major predictors for healthcare-seeking behavior.