Factors influencing health-related quality of life in patients with Barrett’s esophagus: a qualitative focus group study

Abstract

Introduction Barrett's esophagus is a premalignant condition in the lower part of the esophagus, caused by gastroesophageal reflux disease. Previous studies found that having a Barrett's esophagus is associated with a significant decrease of health-related quality of life (HRQOL). Over the past decade, a considerable amount of literature has been published on the development of endoscopic treatment for (early) neoplasia in Barrett's esophagus. Though, currently very little is known about the impact of those endoscopic treatments on HRQOL from the perspective of patients. In this study, we aim to assess the factors influencing HRQOL according to Barrett's esophagus patients. Methods By using a qualitative focus group design, patients with nondysplastic Barrett's esophagus and patients with a history of endoscopic treatment for Barrett's dysplasia were included. Data were analysed following the conventional content analyses approach. Results A total of 34 patients participated in the four focus group sessions. Experiencing symptoms was valued as the most important factor in both groups. Other factors identified as important HRQOL influencers were: use of medication, fear of cancer and trust in physicians and endoscopic procedures. Conclusions In general, Barrett's esophagus patients experienced a good HRQOL, with a minimal emotional burden from the diagnosis of Barrett's esophagus. Most influencing factor on HRQOL was: experiencing reflux and dyspepsia symptoms. This study underlines the importance of adequate gastroesophageal reflux treatment and providing information to Barrett's esophagus patients, tailored to their personal needs.

Barrett Esophagus: Quality of life and factors associated with illness perception

“… 18 This finding suggests a minimal influence on generic HRQoL by the diagnosis of BE. This coincides with our earlier observations in focus‐groups interviews 32 and a single center questionnaire study, 6 which showed Dutch BE patients experience a good HRQoL. Nevertheless, this finding contradicts previous studies, which have concluded that patients with BE reported decreased HRQol on the SF‐36, compared to norm reference data.…”

“…18 This finding suggests a minimal influence on generic HRQoL by the diagnosis of BE. This coincides with our earlier observations in focus-groups interviews 32 and a single center questionnaire study, 6 contradicts previous studies, which have concluded that patients with BE reported decreased HRQol on the SF-36, compared to norm reference data. A more recent study in the UK showed NDBE patients had significantly lower scores across all domains of the SF-36 compared to a healthy cohort.…”

“…We believe that it is beneficial to evaluate care through patient experiences. Previous qualitative studies found trust and communication with the physician as important factors influencing quality of life in BE patients 44–46 …”

“…Previous qualitative studies found trust and communication with the physician as important factors influencing quality of life in BE patients. 44 , 45 , 46 …”

How are we measuring health-related quality of life in patients with a Barrett Esophagus? A systematic review on patient-reported outcome measurements

“…Four studies with a qualitative design were identified: one study used a focus group design and three used patient interviews [43][44][45][46]. The study characteristics and quality scores are demonstrated in Table 3.…”