Hilary Ugras, NP, is a nurse practitioner in GI motility at Beth Israel Deaconess Medical Center.

Hilary Ugras, NP

In ‘Strategies to Improve Treatment Adherence in EoE Care,’ our panel explores strategies for selecting treatments that patients can realistically incorporate into their daily lives and remain adherent to over time. The expert faculty emphasize shared decision-making as a central component of adherence, highlighting the importance of giving patients an active role in choosing among available EoE treatment approaches.

Strategies to Improve Treatment Adherence in EoE Care

The panelists discuss how treatment selection should account for individual preferences, routines, and the practical demands associated with each option. Rather than expecting patients to make an immediate decision during an office visit, the panel describes giving patients time to consider how different therapies may fit into their lifestyle. This may include thinking about whether dietary changes are sustainable long term or whether a patient is comfortable committing to a daily medication regimen. By identifying potential barriers before treatment begins, clinicians can work with patients to select an approach they are more likely to maintain.

The discussion also highlights the value of clear communication and continued engagement after the initial visit. The panelists describe providing written information and patient education materials that allow individuals to review treatment options, potential adverse effects, and other considerations at their own pace. Follow-up through patient portals can then provide an opportunity to answer additional questions, revisit concerns, and move treatment decisions forward. Throughout the episode, the panel of experts underscores that adherence begins with selecting a treatment that is both clinically appropriate and feasible for the individual patient. Incorporating patient preferences, education, and ongoing communication into treatment decisions can help support sustained engagement with EoE therapy over time.

Our next episode, ‘Overcoming Treatment Access Barriers in EoE,’ examines the insurance, cost, and authorization challenges that can delay treatment and monitoring for patients with EoE. The panelists share practical strategies for navigating these barriers through clear documentation, patient communication, financial assistance resources, and team-based support.

Videos

Adherence starts with finding a treatment patients can realistically sustain. The expert faculty discuss how shared decision-making and patient education can help translate an EoE treatment plan into long-term action.

In this episode, ‘Adjusting Treatment and Quality of Life in EoE,’ the panelists explore how clinicians can approach treatment modification when eosinophilic esophagitis is no longer adequately controlled and how quality-of-life considerations can inform long-term management. The expert faculty first discuss the importance of determining why a patient has lost disease control, including whether treatment adherence, changes in dosing, insurance barriers, or other factors may be contributing to loss of histologic response.

Adjusting Treatment and Quality of Life in EoE

When a change in therapy is needed, the panelists emphasize returning to a patient-centered approach and reassessing both disease characteristics and individual treatment priorities. They discuss how symptoms, endoscopic and histologic findings, fibrostenotic features, and prior treatment response can help determine whether to optimize the current approach or consider another treatment option. The panel also highlights the importance of revisiting patient preferences over time, recognizing that lifestyle, priorities, and willingness to pursue different therapies may change throughout the course of a chronic disease.

The discussion then broadens to quality of life and its role in long-term EoE management. The panelists examine how symptoms and adaptive behaviors can affect eating, social activities, travel, work, and emotional well-being, while treatment costs, medication access, and the burden of repeated endoscopies can create additional challenges. Throughout the conversation, the expert faculty emphasize shared decision-making and the value of selecting therapies that not only achieve disease control but also remain practical and sustainable for the individual patient. By regularly reassessing both clinical response and the patient's experience, clinicians can personalize long-term EoE management as needs evolve.

The next episode in this series, ‘Strategies to Improve Treatment Adherence in EoE Care,’ features the panelists discussing how shared decision-making, patient education, and consideration of lifestyle and treatment preferences can support adherence. They highlight practical strategies for helping patients select and sustain an EoE treatment approach that works for them.

Effective EoE management requires more than controlling disease activity. The panel explores how evolving clinical needs and quality-of-life considerations can guide treatment decisions over time.

This episode, titled ‘Monitoring Disease Control in EoE,’ features panelists discussing strategies for assessing disease activity and determining appropriate follow-up once patients with eosinophilic esophagitis are established on therapy. The expert faculty emphasize that monitoring requires consideration of both patient-reported symptoms and objective measures, particularly because patients may develop adaptive eating behaviors that can make persistent disease activity less apparent.

Monitoring Disease Control in EoE

The panelists discuss clinical tools that can help identify subtle symptoms and behaviors during follow-up, including questions about liquid chasers, food texture modification, prolonged mealtimes, and difficulty swallowing pills. They also examine the role of endoscopic assessment, histology, and appropriate tissue sampling in confirming continued disease control. Once remission has been established, however, the panel notes that the optimal interval for repeat endoscopy is less clearly defined and often requires an individualized approach.

The expert faculty share how factors such as prior histologic response, history of esophageal stricture, treatment adherence, therapy changes, and recurrent symptoms may influence the frequency of reassessment. They also highlight the importance of regular clinical follow-up, particularly when longer intervals are used between endoscopic evaluations.

Finally, the panel explores practical strategies for maintaining communication between visits. Proactive electronic check-ins can provide opportunities to assess adherence, identify recurrent symptoms or adaptive behaviors, and uncover changes in insurance coverage or other circumstances that may affect treatment. Together, these approaches demonstrate how individualized surveillance and ongoing patient engagement can help clinicians identify changes in disease control and adjust EoE management when needed.

In the next episode, ‘Adjusting Treatment and Quality of Life in EoE,’ panelists will discuss how to approach treatment changes when disease is no longer adequately controlled and how patient priorities, disease characteristics, and treatment adherence inform next steps. They also explore the role of quality of life in personalizing long-term EoE management.

EoE monitoring does not end when remission is achieved. The panel explores how individualized surveillance and ongoing patient engagement can help clinicians recognize changes in disease control over time.

In ‘Defining Treatment Success and Disease Control in EoE Care,’ our panel explores how clinicians and patients can establish meaningful treatment goals and assess disease control following initial therapy for eosinophilic esophagitis. The expert faculty emphasize that successful treatment requires balancing outcomes that matter most to patients with objective measures of disease activity.

Defining Treatment Success and Disease Control in EoE Care

The panelists discuss the importance of first understanding what improvement means to an individual patient. For some, success may mean eating without food sticking, eliminating the need for liquid chasers, or feeling comfortable dining in social settings. Because patients may have lived with EoE symptoms for years, the panel highlights how adaptive eating behaviors can become normalized and persist even after disease control improves. Establishing patient-defined goals early can therefore help clinicians better understand changes in symptoms and quality of life throughout treatment.

The expert faculty also explain why symptom improvement represents only one component of treatment success. Endoscopic improvement and histologic response provide important objective measures of disease activity, particularly because symptoms, endoscopic findings, and histology may not always align. The panel discusses incorporating these complementary measures when determining whether a patient has achieved meaningful disease control after an initial treatment course.

Throughout the episode, the panel emphasizes partnership between clinicians and patients when establishing expectations for treatment. By aligning patient priorities with clinical goals and explaining the need for continued objective assessment, clinicians can help patients understand why feeling better does not necessarily indicate complete disease control. This multidimensional approach provides a more comprehensive picture of treatment response and can help guide the next phase of EoE management.

Our next episode, ‘Monitoring Disease Control in EoE,’ examines how symptoms, patient behaviors, endoscopic findings, and histology can be integrated to monitor patients established on therapy. The panelists also discuss how individual disease history, treatment adherence, and changes in clinical status can guide the timing of reassessment.

Feeling better does not always mean EoE is fully controlled. The panel explores how patient goals, symptoms, endoscopic findings, and histology come together to provide a more complete picture of treatment success.

Hilary Ugras, NP

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