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P181. Patients' and physicians' views on quality of care in inflammatory bowel disease: Initial results from an ongoing prospective IG‑IBD study


A. Bortoli1, A. Kohn2, M. Daperno3, R. D'Incà4, A. Orlando5, F. Bossa6, P. Doldo7, M. Comberlato8, P. Politi9, D. Valpiani10

1Azienda Ospedaliera “G. Salvini” Ospedale di Rho, UO Gastroenterologia, Rho (MI), Italy; 2San Camillo Forlanini Hospitals, U.O. Gastroenterologia, Rome, Italy; 3Azienda Ospedaliera Ordine Mauriziano, S.C. Gastroenterologia, c/o Segreteri Endoscopia Digestiva, Torino, Italy; 4University of Padua, Padua, Italy; 5V Cervello Hospital, Istituto di Medicina Generale e Pneumologia Reparto di Medicina Interna, Palermo, Italy; 6IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; 7Fondazione “Tommaso Campanella”, Catanzaro, Italy; 8Ospedale di Bolzano, Bolzano, Italy; 9Ospedale Di Cremona, Medical Department, Cremona, Italy; 10Ospedale Morgagni, Divisione di Gastroenterologia ed Endoscopia Digestiva, Forli, Italy



Background: Quality of Care (QoC) in IBD management influence patients-perceived quality of life. The aim of this study was to investigate the QoC in IBD across Italy.

Methods: A prospective evaluation was conducted, between April 2010 and February 2011, at 35 IG-IBD centers across Italy, 1014 patients with Crohn's Disease (CD) and Ulcerative Colitis (UC) were prospectively enrolled. Data regarding clinical features, medical treatments, health care consumption (visits, examinations, hospitalizations, etc.) during the preceeding 12 months were enquired. The QoC evaluation was made by means of the Quality of Care Through the Patient's Eyes (QUOTE-IBD) questionnaire, which explores three dimensions: the “importance”, the “performance”, and the “quality impact”. We investigated both patients' and physicians' perception of QoC, and compared inbetween them. The study is still ongoing and the results presented hereby are extrapolated from pre-planned interim analysis, as the study will end after 1‑year follow-up completion (February 2012).

Table 1
 PhysiciansPatients
 MeanSDMeanSD
QoC9.021.19.400.8
Competence8.551.89.571.1
Courtesy9.142.49.650.8
Accessibility9.211.49.441.2
Information9.432.09.311.4
Continuity of care9.011.28.401.4
Autonomy9.531.89.721.4
Costs8.263.29.541.8

Results: 992 out of 1014 (97.8%) patients were totally evaluable: 509 (51%) were UC (median age 46.5 years), and 483 (49%) were CD patients (median age 41.7 years). 351 (70%) patients with UC and 325 (67%) with CD were in remission. An active medical treatment was recorded in 98% IBD patients: 72% mesalazine, 33% immunosuppressants, 28% biologics, 25% steroids, and 8% antibiotics. Almost all IBD patients (96%) underwent blood examinations and 69% endoscopic and/or radiologic examinations during the preceeding year. Physicians' perception of QoC compared with patients' perception showed that patients scored the care dimension “competence” and “costs” higher and “continuity of care” lower than physicians (Table 1).

Conclusions: QoC in this Italian IBD cohort is good, and well compares to previously published results in different European Countries. Physicians' and patients' perspectives are similar, although physicians overscore continuity of cares and underscore competence and costs compared to patients. The results of this study may contribute to ameliorate standards of practice in order to optimize QoC for IBD in Italy.