Treatment Expectations and Drivers of Treatment Satisfaction Among Chronic Idiopathic Constipation (CIC) and Irritable Bowel Syndrome With Constipation (IBS-C) Patients

Abstract

Introduction: To better understand, through qualitative research, treatment expectations and drivers of treatment satisfaction among patients with chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Methods: Semistructured, qualitative interviews were conducted with 40 adult patients in the United States (21 CIC, 19 IBS-C) following participation in a long-term safety study, which involved taking study treatment for CIC/IBS-C. Patients were asked to describe factors that influenced their treatment expectations, satisfaction with the study treatment, and the characteristics of an ideal CIC/IBS-C treatment. Qualitative analysis of verbatim transcripts was performed using ATLAS.ti software and thematic analysis methods. Following the interview, patients completed a survey in which they rated the treatment attributes they considered most important and the symptoms they most wanted to see improve with treatment. Results: The majority of CIC (86%) and IBS-C (74%) patients were satisfied with the study treatment. Primary drivers of treatment satisfaction for both CIC and IBS-C patients included passing bowel movements (BMs) daily, predictability of BM timing, and resolution of abdominal symptoms. Across both conditions, the symptoms patients reported as most important for an ideal treatment to treat included BM frequency (with the aim of achieving BMs that were frequent/daily and predictable in timing), abdominal pain/discomfort, and abdominal bloating. Some differences by condition were noted in patients’ descriptions of an ideal treatment. For example, a higher proportion of IBS-C patients (89%) highlighted desiring predictable BMs, compared with CIC patients (52%). Similarly, a larger proportion of IBS-C patients considered abdominal pain important to improve (IBS-C=68%; CIC=43%). The majority of CIC patients (62%) identified achieving a normal stool consistency as an ideal treatment characteristic, compared with only 11% of IBS-C patients. The treatment attributes patients rated most highly were low cost, daily administration, oral, solid formulation, effective in relieving symptoms, and no side effects apart from diarrhea. Conclusion: The findings provide evidence regarding drivers of treatment satisfaction and important attributes of an ideal treatment for CIC and IBS-C from the patient perspective. Generally, patients desire a treatment that improves both bowel and abdominal symptoms of CIC and IBS-C at a reasonable cost and is easy to take. As treatment satisfaction is an important driver of treatment adherence, it is critical that the above factors are considered when developing new CIC and IBS-C treatments. Disclosure - Rob Arbuckle is an employee of Adelphi Values, Ltd, which is a consultancy whose activities related to the project are funded by Forest Research Institute, and Ironwood Pharmaceuticals; Brooke. Witherspoon is a consultant to Ironwood Pharmaceuticals, Inc and Forest Research Institute; Robyn Carson is an employee of Forest Research Institute and owns stock and/or stock options in Forest. Laboratories, Inc. This research was supported by an industry grant from Forest Research Institute and Ironwood Pharmaceuticals.