P0818 Addressing unmet needs in adult Inflammatory Bowel Disease care
Authors: Playford C , Asghar Z , Armstrong S , Ngomba R , Rochford A 
Published: January 2025

Background

Many patients with Inflammatory Bowel Disease (IBD) are living with unmet needs. Diet and mental health are two areas where IBD management is often reported by patients to be suboptimal, often resulting in patients self-imposing restrictions to their diet and social life to reduce symptoms, despite these efforts often reducing their quality of life further1. Optimal patient management requires holistic care provided through a specialist Multidisciplinary Team (MDT)2; however, a recent IBD report3 in the United Kingdom (UK) found adult IBD services to be lacking certain members of the MDT, especially dietitians and psychologists.

Methods

Observational cross-sectional study. Two self-administered surveys, one for patients and one for clinicians, were advertised through the Crohn’s and Colitis UK (CCUK) website, social media platforms of CCUK and National Institute for Health and Care Research, Applied Research Collaboration, East Midlands (NIHR ARC EM) and the researchers’ professional networks. Patients with IBD aged ≥18 years and clinicians working in an IBD MDT were identified through convenience sampling. The Statistical Package for Social Sciences (v27) was used for statistical analysis. A P-value &lt;0.05 was considered statistically significant.

Results

91 patients and 16 IBD clinicians completed the surveys. The characteristics of the survey participants can be found in table 1. 29 (32%) patients had seen a dietitian as part of their care and just 2 (2%) patients reported having seen a psychologist. This is unsurprising given 99% of patients reported that they had never been, or had the option to be, referred for psychological support. 95% of patients felt that their mental health is at least sometimes linked to their diagnosis of IBD. The majority of clinicians stated that they routinely discussed diet and mental health in consultations; however, the opposite was reported by patients. Clinicians reported that it is a challenge to meet the holistic needs of their patients (13, 81%) and often did not feel equipped to address diet and mental health concerns, primarily due to limited resources and a lack of knowledge and training in these areas. 81% of the clinicians felt dissatisfied with the current care they provide to their patients.

Conclusion

The unmet needs reported by patients is highlighted by the discrepancy between the experience of care provision reported by clinicians and patients. Further research is required to explain why this discrepancy exists and to explore ways to bridge these gaps therefore improving patient experience and potentially outcomes1,4. For effective provision of person-centred care, complete, holistic IBD teams are required.

References

1.Miglioretto C, Beck E, Lambert K. What do people with inflammatory bowel disease want to know about diet? The dietary information needs of people with inflammatory bowel disease and perceptions of healthcare providers. J. Hum. Nutr. Diet. 2024; 37: 706-716. DOI: 10.1111/jhn.13297.

2.NICE (2015) Inflammatory bowel disease. Quality standard. https://www.nice.org.uk/guidance/qs81/chapter/Quality-statement-2-Multidisciplinary-team-support (accessed 4 November 2024).

3.IBD UK (2021) Crohn’s and Colitis Care in the UK. The Hidden Cost and a Vision for Change. https://crohnsandcolitis.org.uk/media/k01ojh41/ibd-national-report.pdf (accessed 04 November 2024).

4.Regueiro M, Click B, Anderson A, et al. Reduced Unplanned Care and Disease Activity and Increased Quality of Life After Patient Enrollment in an Inflammatory Bowel Disease Medical Home. Clin. Gastroenterol. Hepatol. 2018; 16: 1777-1785. DOI: 10.1016/j.cgh.2018.04.007.