Supplementary Material for: Quality of care in inflammatory bowel disease through patients’ eyes: Validation of the Portuguese version of IQCARO-QoC questionnaire

Introduction: Patients’ perspectives on quality of care are increasingly recognized as a critical dimension of healthcare quality, yet remain insufficiently assessed. The IQCARO-QoC is a questionnaire designed to capture perceptions of care of inflammatory bowel disease (IBD) patients, as well as to identify areas for improvement. The primary aim of this study was to translate and validate the Portuguese version of the IQCARO-QoC, while also exploring factors associated with higher patient-perceived quality of care.
Methods: This was an observational, single-center, cross-sectional study. Following translation into Portuguese, the IQCARO-QoC was administered to IBD patients in the outpatient setting. Patients also completed a visual analogue scale (VAS) for perceived quality of care, as well as the Portuguese versions of both the QUOTE-IBD and the Short IBD Questionnaire (SIBDQ). Thirty patients were invited to complete the questionnaire twice, with a minimum interval of one month. IQCARO-QoC reliability, validity, and responsiveness were assessed. Validity was assessed through correlations between IQCARO-QoC and both QUOTE-IBD and VAS, while reliability was examined through internal consistency, test-retest reproducibility, and intraclass correlation.
Results: One hundred and fourteen patients with IBD (72 with Crohn’s disease and 42 with ulcerative colitis) completed the questionnaire at baseline. The median PT-IQCARO-QoC score was 10 (9-10). The instrument demonstrated high internal consistency (Cronbach’s α = 0.705) and intraclass correlation coefficient (0.759). PT-IQCARO-QoC scores correlated positively and significantly with PT-QUOTE-IBD (r = 366, p = 0.006) and VAS (r = 0.413, p < 0.001). Among demographic and disease-related variables, higher PT-IQCARO-QoC scores were associated with higher SIBDQ-PT scores (r = 0.224, p = 0.017), and with patient-reported disease remission (p = 0.038).
Conclusion: The Portuguese version of the IQCARO-QoC is a simple, valid, and reliable instrument for capturing IBD patients’ perspectives of quality of care. Higher perceived quality of care was associated with self-reported remission and better quality of life. Key areas for improvement were identified, particularly access to the IBD team during flares.