P610. “Living Well with IBD”: The role for structured education and non-medical intervention in enhancing quality of life
O. Kelly1, M. Forry1, E. McDonnell1, J. Wilson-O'Raghallaigh1, S. Patchett1, 1Beaumont Hospital/Royal College of Surgeons in Ireland, Gastroenterology, Dublin, Ireland
There is increasing evidence that non medical interventions can boost performance of medical therapy and improve symptoms and quality of life in patients with chronic disease. The concept of self management in appropriately selected patient cohorts has gained popularity in IBD as an adjunct to conventional medical therapies. With this in mind, we aimed to provide a half-day programme of non-medical interventions to patients diagnosed with IBD designed to complement their medical management with simple and effective educational and psychological techniques.
A half-day programme of education on medical treatment, nutritional advice, stress management and specific psychological strategies in IBD was devised. Patients between 18–40 were identified from a computerised IBD database and written invitations to attend were issued. Response rates were >70%. The number of participants was limited in order to provide maximal benefits and 2 half days were run. Participants were asked to fill in a questionnaire. Patient demographics were recorded. Disease activity was assessed using Crohn's Disease Activity Index (CDAI) or Mayo scoring. The Short Health Scale, IBD Disability Index and a modified Beck inventory measured general health, disability and mood. Patients disclosed current coping strategies, feedback on sessions and commented on acceptability of further potential interventions. Data collected were then statistically analysed.
35 patients (54% male) participated with a median age of 32 (IQR 25–37). 68% had Crohn's Disease, 28% Ulcerative Colitis. 55% patients were taking immunomodulatory or biologic agents and 25% had previous surgery. Median CDAI and Mayo scores were indicative of moderate severity. However, the majority of patients scored moderate-severe in terms of disability indices and general well being. 70% used avoidance as a coping strategy prior to the education sessions with the rest using problem solving, relaxation or distraction techniques. 80% found the stress management sessions most helpful, 68% ranked medical education and/or nutrition highest. 100% of participants felt pursuing further education on self management would improve their quality of life.
Based on the needs identified through patient feedback, a scientifically structured education programme for self-management “Living with IBD” has been introduced in our institution with plans for a nationwide strategy in the near future.