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NO002 Assessing the satisfaction levels of older patients with different types of follow-up care for inflammatory bowel disease

L. Younge*1, J. Lindsay1, L. Langmead1, W. Czuber - Dochan2

1Barts Health, IBD, London, United Kingdom, 2KCL, School of Nursing, London, United Kingdom

Background

Inflammatory Bowel Disease (IBD) affects approximately 240,000 individuals in the UK (Mowett et al 2011). Although it predominantly affects young people, recent evidence suggests a second peak of onset in the over 60's (Charpentier et al 2013). In addition, an aging population means increasing numbers of older people are living with IBD. Long term follow-up (FU) in secondary care is undertaken to monitor IBD and its treatment. New approaches to FU promote self-management and the use of telephone and web access (Kennedy 2004, Kreir 2011). Such approaches reduce unnecassary FU in clinic, whilst enabling ease of access when required. Whilst data suggests such FU methods are well recieved (Pearson 2006, Cima 2007),it is possible that IBD patients diagnosed at an older age, or with a lot of FU experience, may feel less familiar with such approaches and therefore less supported. Aims of Study: 1. To explore levels of engagement of IBD patients aged 60 or over with current FU approaches. 2. To determine their satisfaction levels with services provided. 3. To identify unmet needs specific to older patients.

Methods

179 male and female patients aged > 60 with confirmed IBD who had attended FU services for at least one year were identified from the hospital's IBD database. A postal Likert-type satisfaction tool was used, with prepaid reply envelopes, and reminder letters sent once to non-responders. Quantitative and qualitative data was collected to elicit views on current FU services. Quantitative data was analysed using SPSS. Qualitative data was grouped into themes where possible.

Results

52 patients responded (29%). Mean age was 67 (range 60-79) and median length of diagnosis 30 (4-60) years. Overall, satisfaction levels with FU arrangements were mixed. 49% respondents disagreed with the idea of telephone appointments replacing face-to-face appointments. 73% knew how to get in touch between appointments; of these, 49% had concerns about messages being picked up. Mean satisfaction scores were lower for email vs telephone contact (1.75 vs 3.11). 92% patients were confident about their IBD medications; 60% were confident to alter a dose, but only 22% were happy to start new medications by telephone.

Conclusion

Telephone FU replacing traditional appointments was not well received in this group, differing from other data in younger age groups suggesting such a service would be well recieved ((Bager et al 2013). Concerns were also raised about telephone and email access between appointments with lower satisfaction scores than previously reported in the literature(Pearson 2006, Cima 2007). More work is needed to determine if these findings are specific to this patient group, or a general view of the services provided at this hospital.