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P134. A change in the attention to patients with inflammatory bowel disease: An integrated care unit

L. Sanromán, V. Hernández, J.R. Pineda, L. de Castro, J.A. Hermo, P. Estevez, J.I. Rodríguez

Complexo Hospitalario Universitario de Vigo, Vigo, Spain

Introduction: Inflammatory bowel disease (IBD) includes a group of chronic diseases that predominantly affect the large and small bowel, characterized by a relapsing, unpredictable course. As flares are difficult to predict, patients seek non-programmed medical attention, mainly in emergency departments, which could lead to some inconveniences (long waiting time, attendance by inexperienced staff, unnecessary tests). For treatment, due to the use of drugs that require monitoring by trained staff, it becomes necessary to create a specific unit characterized by an immediate communication with professionals.

In our hospital, an integrated care unit coordinated by a nurse, is been developped, aiming to improve patients education, drug monitoring and a direct phone contact with health care providers.

Aim: To describe the activity of our IBD integrated care unit from the beginning of its work.

Methods: From 1st January 2009 to 31st October 2010, data regarding educational and drug monitorig visits and telephone calls were prospectively collected.

Results: During the study period, 1301 nurse visits were performed, being the drug monitoring visits the more frequent ones (54%). Nineteen patients out of 277 on immunosuppressant or biological therapy developped side effects that required drug discontinuation. A total of 995 phone calls were registered (76% performed by patients and the remaining 24% by the nursing staff). About 69% of the calls were perfectly managed by the nurses and the remaining needed the help of the medical staff. Of the 995 phone calls, the problem was solved during the call in 88% of the cases; in 7% of the cases the patient was referred to the outpatient clinic and 2% to the emergency department, the remaining 2% required hospitalization. Regarding the reason of the phone call, in 46% of cases it was due to disease-related symptoms (in 25% because of the onset of a flare).

Conclusions: IBD nursery plays a key role in the IBD unit with a high rate of patients acceptance. Nurse-based drug monitoring is useful in detect relevant side effects. The coordinating, educational and health care tasks developped by IBD nurses improve the quality of health care of the unit, resulting in fewer hospitalizations or referrals to the emergency department.