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P183 Psychosocial impact of inflammatory bowel disease and its practice management as perceived by patients and physicians in Spain. The ENMENTE Project

Barreiro-de Acosta M.*1, Gobbo Montoya M.2, Cañas M.3, Panadero A.4, Modino Y.5, Guardiola J.6, Cea-Calvo L.7, Juliá B.7, Romero C.7, Carmona L.8, Marín-Jiménez I.9

1Complexo Universitario de Santiago de Compostela, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Santiago de Compostela, Spain 2Positivamente, Centro de Psicología, Madrid, Spain 3Hospital Clínico San Carlos, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Madrid, Spain 4Asociaciόn de Enfermos de Crohn y Colitis Ulcerosa de Madrid (ACCU Madrid), Psicόlogo especializado en Enfermedad Inflamatoria Intestinal, Madrid, Spain 5Confederaciόn de Asociaciones de pacientes de enfermos de Crohn y Colitis Ulcerosa de España (ACCU España), Madrid, Spain 6Hospital Universitari de Bellvitge-IDIBELL, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, L'Hospitalet de Llobregat, Barcelona, Spain 7Merck Sharp & Dohme de España, Medical Affairs, Madrid, Spain 8Instituto de Salud Musculoesquelética, InMusc, Madrid, Spain 9Hospital Gregorio Marañόn, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato digestivo e Instituto de Investigaciόn Sanitaria Gregorio Marañόn (IiSGM), Madrid, Spain

Background

Inflammatory Bowel Disease (IBD) may cause psychological morbidity. The ENMENTE project aims to improve the identification and initial management of psychological problems affecting IBD patients in the gastroenterology clinic. The aim of the study was to describe the patients' and physicians' perception about the emotional impact of IBD and its approach by gastroenterologists.

Methods

During April 2016 two surveys were made available on-line, one for IBD patients, on the ACCU Spain website (Confederation of IBD Spanish Patients' Associations) and another one for physicians (n=665) members of GETECCU (Spanish Group for IBD treatment). Both invited their members to participate by email and the patients' survey was announced in social networks. Patients and physicians were asked closed questions about a) how they perceive the impact of IBD on psycho-social aspects, b) how they think the initial management should be and 3), physician behaviours during patients follow-up. A Mann-Whitney test was used to compare 165 valid physicians' questionnaires with a random sample of 165 patients' questionnaires.

Results

912 patients (mean age 39 (±10) years, 67% women, mean duration of IBD 11 (±9) years) and 170 physicians (mean age 44 (±10) years, 58% women, 98% public hospital practice) responded. A high percentage of physicians and patients agreed that IBD influences patients' psychological status, personal relationships and everyday life, and that IBD activity can be influenced by patients emotional status (Table 1, a). Similarly, a high percentage of physicians and patients reported that patients psychological evaluation should be addressed as routine clinical practice in the IBD clinic, and that a clinical psychologist should be part of the IBD clinical team, however the role of the nurse as helping the patients to cope with their disease was less valued by patients than by doctors (Table 1, b). Although >50% of physicians declare to address psychological and social aspects always/nearly always during patients regular visits, this was only perceived by 15–20% of the patients (Table 1, c).

Conclusion

Patients and physicians agree on the impact of IBD on patients' psychosocial aspects and on the importance of addressing it together with a psychologist. However, patients indicate that physicians address these aspects less frequently than doctors perceive. An optimal patient-physician communication would help to refocus on IBD-related morbidity.

Acknowledgements. Funded by Merck Sharp & Dohme of Spain and endorsed by ACCU España and by GETECCU