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Original research
Patient ownership of primary biliary cholangitis long-term management
  1. Jessica Leighton1,
  2. Collette Thain2,
  3. Robert Mitchell-Thain2,
  4. Jessica K Dyson1,
  5. David E Jones1
  1. 1ICM, Newcastle University, Newcastle upon Tyne, UK
  2. 2PBC Foundation, Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Jessica Leighton, ICM, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; jessleighton{at}


Objective Patient ownership of disease is vital in rare diseases like primary biliary cholangitis (PBC). This survey of UK members of the PBC foundation aimed to assess patients’ perception of their disease management, focusing on key biomarkers and problematic symptoms.

Design Registered PBC foundation members were surveyed on their experiences on their most recent clinic visit, covering the type of hospital and clinician and whether biochemical response and symptom burden were discussed, including who initiated these conversations. Respondents were also asked about their willingness to initiate these conversations.

Results Across 633 respondents, 42% remembered discussing alkaline phosphatase, the key biochemical response measure, and the majority of discussions were initiated by the healthcare provider. 56% of respondents remembered discussing itch, a key PBC symptom. There was no distinction between the grade of healthcare professional, but both patients and clinicians were significantly more likely to discuss symptoms over disease progression. Reassuringly, 84% of respondents felt willing to initiate conversations about their illness, regardless of the grade of managing clinician.

Conclusions This work lays a positive foundation for patient education and empowerment projects, likely to improve clinical outcomes. Key aspects of management (biochemical response to treatment and symptom burden) should be emphasised as topics of discussion to both patients and clinicians managing PBC. We suggest a simple cue card to prompt patient-led discussion.

  • primary biliary cirrhosis
  • autoimmune liver disease
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  • Contributors JL and DEJ planned the study. JL, JD and DEJ wrote the paper. CT and RMT facilitated delivery of the survey via PBC Foundation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information. Please contact JL for further data queries.

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