P397 Approach and management of psychological aspects of inflammatory bowel disease described by patients and physicians in Spain. The ENMENTE Project
Marín-Jiménez I.*1, Panadero A.2, Gobbo Montoya M.3, Cañas M.4, Modino Y.5, Guardiola J.6, Cea-Calvo L.7, Juliá B.7, Romero C.7, Carmona L.8, Barreiro-de Acosta M.9
1Hospital Gregorio Marañόn, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato digestivo e Instituto de Investigaciόn Sanitaria Gregorio Marañόn (IiSGM), Madrid, Spain 2Asociaciόn de Enfermos de Crohn y Colitis Ulcerosa de Madrid (ACCU Madrid), Psicόlogo especializado en Enfermedad Inflamatoria Intestinal, Madrid, Spain 3Positivamente, Centro de Psicología, Madrid, Spain 4Hospital Clínico San Carlos, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, 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 9Complexo Universitario de Santiago de Compostela, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Santiago de Compostela, Spain
ECCO guidelines recommend psychological counseling of IBD patients in clinical practice. The aim of ENMENTE project was to describe patients' and physicians' perceptions on how these aspects are managed in gastroenterology clinics in Spain
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 patients' survey was announced in social networks. Patients and physicians responded to closed questions about how they perceive a) the impact of IBD on psychological and social aspects, b) the actual and the ideal care of this impact and c) the management and treatment of psychological morbidities in clinical practice. Quantitative variables are expressed as the mean and standard deviation (SD), qualitative variables are described as percentages
912 patients (mean age 39 (±10) years, 67% women) and 170 physicians (mean age 44 (±10) years, 58% women) responded to the survey. For 48% of physicians the control of psychological comorbidity is part of the therapeutic objectives. Most physicians reported to have limited (60%) or no experience (33%) in detecting psychological disorders or managing psychotropic drugs. Only 10% have a psychologist as part of the clinical team, and only 6% manage psychotropic drugs in case of anxiety or depression; most of them refer patients to a psychiatrist, psychologist or to patients associations (Figure 1)
Only 15% of physicians reported that patients ask psychological support, although up to 36% of patients declared that they always/ mostly spontaneously discuss their emotional status with their doctor. A total of 69% of IBD patients reported that they have never received psychological support to cope with IBD, have never been referred to a psychiatrist (84%), psychologist (77%) nor ever have received a prescription for psychotropic drugs (72%).
Although nearly half of the doctors consider the control of the psychological comorbidity part of the therapeutic objectives, ability or support to manage it is scarce. Only 10% of physicians have a psychologist as part of a multidisciplinary team, and 7 out of 10 patients have never received psychological support to cope with their IBD.
Acknowledgements. Funded by Merck Sharp & Dohme of Spain and endorsed by ACCU España and by GETECCU