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PWE-108 Factors Influencing The Management Of Inflammatory Bowel Disease In Primary Care
  1. SA James1,
  2. CR May2,
  3. M Simon2,
  4. JF Cummings1
  1. 1Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, UK
  2. 2Faculty of Health Sciences, University of Southampton, Southampton, UK

Abstract

Introduction Between 30–70% of United Kingdom (UK) adults with Inflammatory Bowel Disease (IBD) are managed solely by their General Practitioner (GP).1,2 There is, however, limited knowledge as to how UK GPs manage this patient group and whether GP-led care meets IBD Standards.3 This study aimed to identify factors influencing long-term follow-up of adults with IBD by GPs; achieved through examining GPs’ knowledge and management of IBD, including exploration of future IBD-care models.

Methods A non-probability, convenience sample of 34 Senior Partner GPs and 130 Colleague GPs was recruited from 37 surgeries within Southampton City Primary Care Trust. Pre-piloted, closed and open-response e-questionnaires were administered to GPs asking questions on demographics, epidemiology, knowledge and management of IBD. Univariate and bivariate descriptive analyses with 90% confidence intervals were utilised. Conventional content analysis was applied to open question responses.

Results Cumulative questionnaire response rate was 50% (n = 82/164); 58% of GPs were male, with 19 mean years (SD 9.10) practicing medicine and 13 (SD 9.41) as a GP. Estimated IBD prevalence was 471:100,000. General Practitioners consulted with 2.8 adult patients (0.7%/total patients) with IBD/month and 59% independently managed those with established IBD. Short consultation times, insufficient knowledge and confidence in managing IBD and inadequate finances were identified as detrimental to GPs independently managing this patient group. Shared-care with hospital IBD services was preferred (82%).

Conclusion A high proportion of adults with stable IBD are being managed solely by GPs. General Practitioners’ lack of knowledge, confidence and resources in caring for patients with IBD inevitably occurs when managing an infrequently seen chronic condition; raising clinical governance concerns. Low exposure to this patient group questions cost-effectiveness of measures to improve GPs’ knowledge-base. Findings support a shared-care approach between primary and secondary care; meeting the long-term health needs of adults with IBD.

References

  1. Rubin GP, Hungin AP, Kelly PJ, Ling J. Inflammatory bowel disease: epidemiology and management in an English general practice population. Alim Pharmacol Ther 2000;14(12):1553–59

  2. Stone MA, Mayberry JF, Baker R. Prevalence and management of inflammatory bowel disease: a cross-sectional study from central England. Eur J Gastroenterol Hepatol. 2003;15(12):1275–80

  3. The IBD Standards Group. Standards for the healthcare of people who have Inflammatory Bowel Disease (IBD). IBD Standards. 2013 Update. Brighton: Oyster Healthcare Communications Ltd 2013

Disclosure of Interest None Declared.

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