Bowel disease questionnaire developed for pharmacies

Twenty community pharmacies in Western Australia are trialling a short, simple and self-administered questionnaire for people with bowel problems.

Developed by Curtin University researchers, the questionnaire is intended to help pharmacy staff determine if medical follow-up is required, in a move to promote early identification and treatment.

The Jodi Lee test (JLT), named for the foundation sponsoring the research, has been specifically designed for community pharmacies, where an estimated one in 15 people seeking health advice do so for issues with their lower bowel.

PhD candidate Deepa Sriram says the JLT meets a need not met by current tools, namely the Colonoscopy Research into Symptom Prediction (CRISP) questionnaire and the Patient Consultation Questionnaire (PCQ).

"The CRISP and PCQ were developed and validated for bowel symptoms, to be used by doctors to identify when a patient with lower bowel symptoms should be referred to a specialist for tests," she says.

"We trialled the PCQ in WA. While it was useful to identify serious bowel disease, it is not so useful in identifying some apparently less serious conditions that might also benefit from advice from a GP.

"Conditions such as severe haemorrhoids or recurrent constipation that aren't flagged by the PCQ may still benefit from follow-up by a medical practitioner, because these conditions may be symptoms of a more serious condition."

Three-minutes to better health

Consensus among pharmacy staff has been that a shorter and simpler questionnaire was needed, as the PCQ takes 10 minutes to complete and requires a computer-based scoring schedule.

The JLT, on the other hand, has only eight questions, takes approximately three minutes to complete and mostly requires tick-box responses, with no computing.

Researchers developed the test via an extensive literature review, expert panel consultations and sensitivity testing against the PCQ, focussing on symptoms and duration as the most important indicators of a need for further medical advice.

Key symptoms addressed in the JLT include rectal bleeding, change in bowel habit, increased frequency of bowel movements, abdominal pain and/or discomfort, incomplete defecation and pain in the back passage.

It also considers loss of weight and history of gastrointestinal disease.

Under WA law, customers seeking to purchase over-the-counter products for treatment of diarrhoea and rectal bleeding are required to speak with pharmacy staff, increasing the chances that the JLT could help identify serious bowel issues early and potentially save lives.