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Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation.

Abstract

BACKGROUND

The role of psychological factors in irritable bowel syndrome (IBS) remains unclear, particularly in a primary care setting, where relatively little research on this common and costly condition has been carried out. The aim of this study was to investigate the relative contribution of physical and psychological factors to health-related quality of life and health-care utilization in patients with functional bowel disease (IBS-like symptoms) in primary care. We also wished to establish the relevance of formal diagnostic criteria to IBS in the primary care setting.

METHODS

This study used a cross-sectional design. Four hundred twenty patients with functional bowel disorders in primary care completed a series of measures, including bowel symptom status and severity, severity of psychological distress, personality, and quality of life. The number of visits to a general practitioner (GP) in the previous 12 months was recorded.

RESULTS

The following variables were independently and highly significantly associated with health-related quality of life in patients with functional bowel disorders in primary care: total psychological symptom score, diarrhea severity, abdominal pain for >12 weeks, and abdominal distension. A similar pattern emerged between patients who met meet Rome II criteria for IBS and patients who did not meet Rome II criteria for IBS. Relatively few variables (either physical or psychological) had a major impact on the number of GP consultations, with the exception of frequency of bowel movements.

CONCLUSION

This study confirms that psychological factors are significantly associated with health-related quality of life in patients with IBS in primary care. Physical symptom severity is also important. Relatively few symptom measures, either physical or psychological, have a major impact on doctor consultation rates in primary care.

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  • Authors+Show Affiliations

    ,

    National Primary Care Research and Development Centre, University of Manchester, Manchester, United Kingdom.

    , , , , ,

    Source

    Journal of psychosomatic research 64:2 2008 Feb pg 129-38

    MeSH

    Adult
    Cross-Sectional Studies
    Demography
    Diarrhea
    Factor Analysis, Statistical
    Female
    Health Services
    Health Status
    Humans
    Irritable Bowel Syndrome
    Male
    Middle Aged
    Physician-Patient Relations
    Primary Health Care
    Quality of Life
    Referral and Consultation
    Self Care
    Severity of Illness Index
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    18222126

    Citation

    Lee, Victoria, et al. "Functional Bowel Disorders in Primary Care: Factors Associated With Health-related Quality of Life and Doctor Consultation." Journal of Psychosomatic Research, vol. 64, no. 2, 2008, pp. 129-38.
    Lee V, Guthrie E, Robinson A, et al. Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation. J Psychosom Res. 2008;64(2):129-38.
    Lee, V., Guthrie, E., Robinson, A., Kennedy, A., Tomenson, B., Rogers, A., & Thompson, D. (2008). Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation. Journal of Psychosomatic Research, 64(2), pp. 129-38. doi:10.1016/j.jpsychores.2007.09.004.
    Lee V, et al. Functional Bowel Disorders in Primary Care: Factors Associated With Health-related Quality of Life and Doctor Consultation. J Psychosom Res. 2008;64(2):129-38. PubMed PMID: 18222126.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation. AU - Lee,Victoria, AU - Guthrie,Else, AU - Robinson,Andrew, AU - Kennedy,Anne, AU - Tomenson,Barbara, AU - Rogers,Anne, AU - Thompson,David, PY - 2007/01/11/received PY - 2007/07/30/revised PY - 2007/09/13/accepted PY - 2008/1/29/pubmed PY - 2008/4/9/medline PY - 2008/1/29/entrez SP - 129 EP - 38 JF - Journal of psychosomatic research JO - J Psychosom Res VL - 64 IS - 2 N2 - BACKGROUND: The role of psychological factors in irritable bowel syndrome (IBS) remains unclear, particularly in a primary care setting, where relatively little research on this common and costly condition has been carried out. The aim of this study was to investigate the relative contribution of physical and psychological factors to health-related quality of life and health-care utilization in patients with functional bowel disease (IBS-like symptoms) in primary care. We also wished to establish the relevance of formal diagnostic criteria to IBS in the primary care setting. METHODS: This study used a cross-sectional design. Four hundred twenty patients with functional bowel disorders in primary care completed a series of measures, including bowel symptom status and severity, severity of psychological distress, personality, and quality of life. The number of visits to a general practitioner (GP) in the previous 12 months was recorded. RESULTS: The following variables were independently and highly significantly associated with health-related quality of life in patients with functional bowel disorders in primary care: total psychological symptom score, diarrhea severity, abdominal pain for >12 weeks, and abdominal distension. A similar pattern emerged between patients who met meet Rome II criteria for IBS and patients who did not meet Rome II criteria for IBS. Relatively few variables (either physical or psychological) had a major impact on the number of GP consultations, with the exception of frequency of bowel movements. CONCLUSION: This study confirms that psychological factors are significantly associated with health-related quality of life in patients with IBS in primary care. Physical symptom severity is also important. Relatively few symptom measures, either physical or psychological, have a major impact on doctor consultation rates in primary care. SN - 0022-3999 UR - https://www.unboundmedicine.com/medline/citation/18222126/Functional_bowel_disorders_in_primary_care:_factors_associated_with_health_related_quality_of_life_and_doctor_consultation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3999(07)00362-5 DB - PRIME DP - Unbound Medicine ER -