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Abstract
Introduction Clinical demands and advances in diagnostics and therapeutics have seen a rapid growth in GI physiology/motility services. We surveyed the practice, training and attitudes towards services nationally, to determine if these aspects have kept pace with expansion and to identify areas for development.
Methods An online survey developed by a multi-disciplinary panel with medical, surgical and GI physiology representation was circulated to all GI clinicians and physiologists in the UK & Ireland by their national societies BSG, AGIP, AUGIS and ACPGBI. The survey included both generic questions and specific ones signposted for ‘specialists’ (GI physiologists/clinical leads).
Results 313 responses (59% Gastroenterologists) were received, with 221/313 (71%) from 98 institutions having an on-site GI physiology unit. Most units (88/98) had a clinical lead (60% Gastroenterologists, 34% with ‘subspecialty interest’). Figure 1 summarises the services available nationally. GI physiologists/nurse specialists conduct the majority of studies (69%) and biofeedback (84%). GI physiologists report most studies (Upper GI 71%, Lower GI 69%), however cases are often discussed with a lead clinician prior to finalising (Upper GI: 34% discuss all cases and 38% selected cases; Lower GI: 27% discuss all cases and 27% selected cases), 45% have dedicated multidisciplinary team meetings (MDT) for reporting (held weekly in 72%) and of those without an MDT, 72% felt introducing one would improve provision of therapeutic recommendations. 54% of ‘specialists’ reported that therapeutic recommendations are not routinely made (50% citing reasons such as; no subspecialist clinician/ ‘not qualified’ or ‘not necessary’). Moreover, 70% of ‘specialists’ felt a ‘subspecialist’ clinician is best placed to make such recommendations, whilst only 4% of clinicians without subspeciality interest are comfortable interpreting the data. Overall, very few felt that services (26%), research opportunities (15%) and training (14% for GI physiologists and 10% for clinicians) were adequate, with most GI physiologists (83%) and clinicians (96%) recommending changes with suggestions including an accredited clinical training programme.
Conclusion The survey highlights that GI physiology/motility is a rapidly emerging sub-specialty with limited exposure during clinical training. An MDT approach with subspecialist clinical input facilitates interpretation of complex data and provision of therapeutic recommendations. Percieved deficiencies in current services and training systems have been identified, providing an opportunity to raise awareness nationally via AGIP/BSG and to build on existing training pathways.
Disclosure of Interest None Declared