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P193. Quality of care in inflammatory bowel disease in Italy according to IBD characteristics: Initial results from SOLUTION trial (an ongoing prospective IG‑IBD study)


A. Bortoli1, M. Daperno2, A. Kohn3, F. Castiglione4, M. Comberlato5, P. Politi6, D. Valpiani7, F. Boni8, G. Casella9, M. Merli10

1Azienda Ospedaliera “G. Salvini” Ospedale di Rho, UO Gastroenterologia, Rho (MI), Italy; 2Azienda Ospedaliera Ordine Mauriziano, S.C. Gastroenterologia, c/o Segreteri Endoscopia Digestiva, Torino, Italy; 3San Camillo Forlanini Hospitals, U.O. Gastroenterologia, Rome, Italy; 4University Federico II Of Naples, Gastroenterology, Naples, Italy; 5Ospedale di Bolzano, Bolzano, Italy; 6Ospedale Di Cremona, Medical department, Cremona, Italy; 7Ospedale Morgagni, Divisione di Gastroenterologia ed Endoscopia Digestiva, Forli, Italy; 8Ospedale di Melegnano, Melegnano, Italy; 9Ospedale di Desio, Desio, Italy; 10Policlinico Umberto I, Roma, Italy



Background: Quality of Care (QoC) in IBD management may vary according to disease activity and patients characteristics. The aim of this study was to investigate the QoC in IBD in 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, helth 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. 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).

Results: 992 out of 1014 (98%) patients were included in the analysis: 509 (51%) were UC patients, and 483 (49%) were CD patients, respectively. Among UC cases 351 (70%) were in remission (median Lichtiger score 2, IQR 1–4), while among CD cases 325 (67%) were in remission (median Harvey–Bradshaw index 3, IQR 1–5). Two third of the patients (68%) were followed-up at Community Hospitals, and the remaining at University Hospitals. Mean QUOTE-IBD results stratified according to disease diagnosis, age groups and disease activity are reported in Table 1.

Table 1. Results
  UCCD  
(mean)UC–CD<30 yrs30–50 yrs>50 yrs<30 yrs30–50 yrs>50 yrsUC Rem-UC ActCD Rem-CD Act
QoC9.39–9.429.379.329.499.259.399.629.40–9.369.45–9.36
Competence9.55–9.589.569.529.599.369.599.719.54–9.629.63–9.48
Courtesy9.62–9.689.649.569.679.469.709.789.62–9.609.73–9.56
Accessibility9.37–9.519.449.299.459.359.539.609.37–9.409.55–9.45
Information9.19–9.439.279.049.369.329.459.479.24–9.909.45–9.40
Continuity of care8.33–8.468.198.278.488.418.378.668.31–8.388.48–8.40
Accomodation9.61–9.569.399.649.659.129.609.799.61–9.699.62–9.45
Autonomy9.65–9.89.589.559.799.879.699.979.62–9.699.83–9.75
Costs9.76–9.39.899.719.799.089.199.689.88–9.559.16–9.59

Conclusions: Quality of care in this Italian IBD cohort is remarkably high, and its measurement by means of QUOTE-IBD questionnaire seems to be robust and substantially independent from disease subtype, age class or disease activity status. The results of this study may contribute to ameliorate standards of practice in order to optimize QoC for IBD in Italy.