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Important role of physicians in addressing psychological aspects of interstitial cystitis/bladder pain syndrome (IC/BPS): a qualitative analysis

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Abstract

Introduction

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a poorly understood source of chronic pain causing significant morbidity, with variable treatment success. Despite the need to understand patient perspectives in chronic pain, there is a paucity of qualitative data for IC/BPS. We aimed to acquire information regarding patient experience with IC/BPS symptoms and with their medical care to elicit suggestions to improve patient satisfaction with that care.

Methods

Fifteen women with IC/PBS participated in a total of four focus groups. Sessions were recorded and transcribed and information deidentified. Focus groups were conducted until thematic saturation was reached. All transcripts were coded and analyzed by a minimum of three independent physician reviewers. Investigators identified emergent themes and concepts using grounded-theory methodology.

Results

Participant’s mean age was 52.6 years, with an average IC/BPS duration of 6.3 years. Thematic saturation was reached after four focus groups. We identified three emergent patient experience concepts: IC/PBS is debilitating, the disease course is unpredictable and unrelenting, and patients experience significant isolation. Importantly, suicidal ideation was expressed in each group. Patients voiced strong preference for physicians who provided education regarding the condition, an array of treatment options, organized treatment plans, and optimism and hope regarding treatment outcomes.

Conclusions

Our study presents novel findings of the importance of patient–physician interaction in IC/BPS and reinforces the tremendous disability and burden of this disease, which frequently manifests in suicidal ideation. Patients preferred organized treatment plans with diverse choices and providers who offered hope in dealing with their condition.

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Acknowledgments

Thanks to Ambroshia Murrieta and Heidi Rishel Brakey for their excellent work moderating focus groups and providing input on the focus group script.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, MSC 10-5580, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA

    Gregory Kanter, Katherine A. Volpe, Gena C. Dunivan, Sara B. Cichowski, Peter C. Jeppson, Rebecca G. Rogers & Yuko M. Komesu

Authors
  1. Gregory Kanter
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  2. Katherine A. Volpe
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  3. Gena C. Dunivan
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  4. Sara B. Cichowski
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  7. Yuko M. Komesu
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Corresponding author

Correspondence to Yuko M. Komesu.

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Funding

This project was supported (in part or in full) by the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health through Grant Number UL1 TR001449. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Conflicts of interest

G. Kanter: Travel support from Medtronic for educational course

KA Volpe: None

GC Dunivan: Research support from Pelvalon, Inc.

SB Cichowski: None

PC Jeppson: None

RG Rogers: DSMB Chair for the TRANSFORM trial sponsored by American Medical Systems, UptoDate royalties, Royalties from McGraw Hill for a textbook

Y Komesu: None

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Kanter, G., Volpe, K.A., Dunivan, G.C. et al. Important role of physicians in addressing psychological aspects of interstitial cystitis/bladder pain syndrome (IC/BPS): a qualitative analysis. Int Urogynecol J 28, 249–256 (2017). https://doi.org/10.1007/s00192-016-3109-2

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