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P652 Unmet needs of physicians managing inflammatory bowel disease. A Survey of the Italian Group for Inflammatory Bowel Disease (IG-IBD)

Saibeni S.*1, Bezzio C.1, Armuzzi A.2, Bossa F.3, Calabrese E.4, Caprioli F.5, Daperno M.6, Mocciaro F.7, Orlando A.8, Papi C.9, Rispo A.10, Rizzello F.11 IG-IBD

1ASST Rhodense, Gastroenterology Unit, Rho, Italy 2Policlinico Gemelli, Rome, Italy 3Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy 4Policlinico Tor Vergata, Rome, Italy 5University of Milan, Milan, Italy 6Ospedale Mauriziano, Torino, Italy 7Ospedale Arnas Civico, Palermo, Italy 8Ospedale Cervello, Palermo, Italy 9Ospedale San Filippo Neri, Rome, Italy 10Policlinico Federico II, Naples, Italy 11University of Bologna, Bologna, Italy

Background

It is known that patients affected by Inflammatory Bowel Disease (IBD) present several unmet needs about the management of their illness and its consequences on their Health Related Quality of Life. However, little is known about the unmet needs of physicians caring IBD patients. The aim of the study was to investigate the difficulties and the problems of Italian physicians managing IBD.

Methods

A questionnaire was submitted to physicians attending the National Congress and the Residential Courses of IG-IBD.

Results

280 physicians (156 men) completed the questionnaire. Mean age ± SD was 44.4±10.7 years; 95 (33.9%) were working in Academic hospitals. On a 5-point Likert scale, the most problematic issues in managing IBD patients were: increasing bureaucratic charge (3.9±1.2), lacking of extra-gastroenterological IBD expertise (3.4±1.4), lacking of diagnostic techniques (3.1±1.4), budget limitations (2.9±1.3), drugs safety (2.9±1.2), difficulties in guidelines application (2.7±1.2), pharmacy's limitations (2.2±1.1). Ranking from 0 to 9 the most lacking extra-gastroenterological IBD specialist figures led to the following classification: surgeon (2.5±2.5), nobody (3.3±3.4), rheumatologist (3.8±2.3), nutritionist (3.8±2.0), psychologist (3.8±2.2), dermatologist (4.2±2.0), pathologist 4.3±2.5), radiologist (4.8±2.6), stoma therapist (5.4±2.4). Ranking from 0 to 9 the most lacking techniques led to the following classification: nothing (1.6±1.8), anti-drug antibody and trough levels assays (2.7±3.0), enteroscopy (3.1±2.0), exploration under anesthesia of perianal disease (3.2±2.1), entero-MR (3.2±2.4), bowel ultrasonography (3.3±2.8), videocapsule endoscopy (3.9±2.1), entero-CT scan (4.4±2.1), fecal calprotectin (4.7±3.0).

Conclusion

In Italy, several situations appear to potentially limit the best management of IBD patients. However, most of them appear to be correctable.