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P184. Optimal care in Crohn's disease and ulcerative colitis: how aligned with patients' needs and expectations are health care providers?

J.K. Marshall1, P. Lazure2, P. Pare3, U. Chauhan1, J. Bernier4, C. Montgrain4, S. Hayes2, 1McMaster University, Medical Centre, Division of Gastroenterology, Toronto, Canada, 2AXDEV Group, Performance Improvement Research, Brossard, Canada, 3Hôpital du St-Sacrement, CHAUQ, Quebec, Canada, 4Abbvie, an Abbott Corporation, Continuing Health Education, Montreal, Canada

Background

Crohn's Disease (CD) and Ulcerative Colitis (UC) are complex inflammatory bowel diseases (IBD) that require healthcare providers (HCP) to obtain a clear understanding of a patient's particular needs, expectations towards care and attitude towards disease, in order to offer optimal care. An IBD needs assessment was undertaken to identify discrepancies between patients' needs/expectations and the care offered by HCP.

Methods

The study included two (2) discussion groups with CD/UC patients (n = 15) which informed the development of two quantitative surveys: one deployed among patients and caregivers (n = 76), and one among HCP, including Gastroenterologists (n = 93) and Nurses / Nurse Practitioners (n = 44). Responses from HCP and patients/caregivers were compared.

Results

Two specific discrepancies between the patients' needs and HCP's expertise were identified. The first one relates to addressing the emotional component of the disease. 51% of patients reported that the healthcare team poorly discussed the emotional impact of their diagnosis with them, although 61% of patients perceived this as important. In addition, up to 74% of HCP respondents reported a lack of skills in different aspects of emotional support.

The second discrepancy concerns the nutritional aspects of IBD care. Patients did not receive the information they expect on the impact nutrition could have on their disease (61%), nor the specific nutritional recommendations they believed they need (66%). In addition, 79% of Gastroenterologists and Nurses reported lacking skills to provide nutritional information and its rationale, and only 51% of Nurses/34% of Gastroenterologists reported they often or consistently explain to their patients the role of nutrition in UC/CD.

Conclusion

The results from this study question whether patients' expectations and needs are known and understood. While the gap in emotional support may reflect gaps in HCP skill sets, the gap in nutritional information is at least partly explained by a lack of clear evidence and guidance on the role of nutrition in UC/CD. Regardless, patient-centric practice requires that HCP understand and address the expectations of IBD patients to improve communication, enhance compliance and optimize health outcomes.