Diverticulitis evaluation of patient burden utilization and trajectory

Brief description of study

Half of all Americans over the age of 60 have diverticulosis of the colon, and 20-25 % develop acute diverticulitis. While most episodes resolve with antibiotics alone, 10-20 % of those with acute diverticulitis will have an emergency colectomy/colostomy at their initial presentation and all remain at lifetime risk for recurrent episodes. Given the uncertainty of when and where a recurrent episode will occur and the looming risk of colostomy, surgeons have, until very recently, been trained to recommend elective, prophylactic colectomy after 2 episodes, and earlier for those < 50 years of age. As a result, diverticulitis is now the leading reason for elective colectomy. However, counseling patients after recovery from an episode of diverticulitis is challenging because less than 5% will go on to need emergency surgery, and the rate of recurrence for patients who have had an elective resection (5-11 %) is similar for those who do not (4-13 %). The DEBUT study will examine both clinical and non-clinical reasons for pursuing surgery, taking into account previously unexplored areas in surgical decision-making including the comprehensive impact of this disease as well as factors that impact a surgeon’s willingness to recommend surgery. Ultimately, this patient-centered research approach will help to understand the impact of treatment decisions on a patient’s quality of life, work, and clinical symptoms; and ultimately help to inform our recommendations for treatment for patients with diverticulitis. Patients will be recruited for study participation after being seen in a clinic visit with a surgeon or gastroenterologist, or after visiting the emergency room with symptoms of diverticulitis. Patients who participate in the DEBUT study will be asked to complete surveys either by phone, email or mail. Surveys will examine quality of life, overall health, and clinical symptoms to understand what drives patients and surgeons to an operation, as well as how that decision impacts quality of life and recurrent events in patients that choose to have surgery compared to those that do not have surgery.

Clinical Study Identifier: s18-01508

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