|Challenges||Mechanism of Impact||Ways to Overcome|
|Acceptance of chronic disease||Unpredictable remitting-relapsing course||Educating patients on treatment options to induce remission and importance of adherence in optimal outcome|
|Impact of UC on quality of life||Physiological distress||Promptly identifying patients who have psychological distress and instituting measures such as taking more time to explain and explore and referral to psychiatrist as needed|
|Non-adherence||Poor outcomes in UC||Shared decision-making; treat-to-target; motivational interviewing|
|Time Course of UC||Patient||Physician’s Role|
|Pre-diagnosis||Endurance of UC symptoms without definite diagnosis resulting in frustration|
|At diagnosis||5 stages of grief||Recognize the patient's stage of grief|
Questions regarding UC:
-Is it infectious?
-Can I be cured?
-Does this disease affect only the GI tract?
|Explain the nature of its relapsing-remitting course and although there is no cure, there are vast treatment options to facilitate remission|
|Feelings of isolation, of carrying disease labels, flaw of how UC will affect their life: career prospects, relationships, children, and activities of daily living||Address concerns. Invite partners to be part of the UC journey. Ascertain the amount of social support. Remedial actions for poor social support|
|Reports of subjective symptoms of UC||Assess pretreatment objective and subjective scores|
|Patients' role as health partners and being jointly involved in the decision-making process in order to reach evidence-based patient-centered decision||Explain the remission induction and remission maintenance options, and come to a joint decision via shared decision-making on treatment strategy|
|Prioritization of symptomatic regression and a misconception of histological remission||Explain the objective and subjective parameters monitored and their importance, and come to an agreement with patients on the treatment targets: stress that failure to achieve would hence result in escalation of therapy|
|Reports of subjective symptoms of UC.||Revisit the subjective and objective parameters monitored to assess if treatment is effective|