Talking about life and IBD: A paradigm for improving patient–physician communication

Despite recent awareness and understanding of quality of life (QOL) issues in IBD, nearly half of physicians in Europe do not ask their IBD patients about their QOL and nearly half of patients do not initiate a conversation with their physicians about QOL, according to a recent survey by the European Federation of Crohn's and Colitis Associations (EFCCA) [S. Ghosh and R. Mitchell, Impact of inflammatory bowel disease on quality of life: results of the European Federation of Crohn's and Ulcerative Colitis Associations (EFCCA) patient survey. J Crohn's Colitis. 2007;1(1):10–20.]. Effective treatment has been shown to help improve QOL in Crohn's disease patients [E.V. Loftus, J.F. Colombel, R. Panaccione, et al, Adalimumab sustains qualify-of-life improvements in patients with Crohn's disease: 2-year data from CHARM [P078]. Poster abstract presented at ECCO 2008, Lyon, France., S.B. Hanauer, B.G. Feagan, G.R. Lichtenstein, et al, Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet 2002;359:1541–1549.], suggesting there is a need to improve physician–patient communication about QOL and new treatment options that may help. To address this need, a multidisciplinary European group initiated by EFCCA (including an IBD consultant, nurse specialist, an IBD patient and two IBD EFCCA representatives/carers) set out to describe the key aspects of an ‘ideal’ IBD consultation and main considerations when talking about the impact of IBD on patients' daily lives. These insights can serve as a framework for developing practical tools to help facilitate IBD patient–physician communication.