Abstract:IBD services must continue to adapt to changes within the National Health Service bearing in mind long-term sustainability and continued care provision. The 'flare card' goes further in an attempt to optimise Crohn's disease and ulcerative colitis management by harmonising clinician evaluation and patient's self-initiation of therapy and investigation.
“…Growing evidence shows that the physician should be accompanied by a figure (case manager) who coordinates the interactions among IBD patient, hospital, and any other parties [ 103 ]. This multidisciplinary strategy should be associated with organizational changes leading to the development of IBD unit including physicians, nurses, and psychologists to meet patients’ needs [ 101 , 104 ] and ensure continuity of care [ 105 ].…”
Background
Inflammatory bowel diseases (IBD) are remitting and relapsing diseases that mainly interest the gastrointestinal tract. IBD is associated with a condition of psycho-social discomfort that deeply compromises the quality of life and the competence of patient to be fully engaged in their self-management. As a consequence, effective care of IBD patients should include not only medical but also psychological support in order to improve patients' wellbeing. Although this, to date there is no standardized approach to promote psychological wellbeing of IBD patients in order to improve the perception of the quality of the care. To fill this gap, a consensus conference has been organized in order to define the psychosocial needs of IBD patients and to promote their engagement in daily clinical practice. This paper describes the process implemented and illustrates the recommendations deriving from it, which focus on the importance of a multidisciplinary approach in IBD management.
Results
The consensus conference has been organized in three phases: (1) literature review about life experiences, engagement, and psychosocial needs of IBD patients; (2) workshops with IBD experts and patients’ representatives; (3) drafting of statements and voting. Seventy-three participants were involved in the consensus conference, and sixteen statements have been voted and approved during the consensus process.
Conclusions
The main conclusion is the necessity of the early detection of – and, in case of need, intervention on- psycho-social needs of patients in order to achieve patient involvement in IBD care.
“…Growing evidence shows that the physician should be accompanied by a figure (case manager) who coordinates the interactions among IBD patient, hospital, and any other parties [ 103 ]. This multidisciplinary strategy should be associated with organizational changes leading to the development of IBD unit including physicians, nurses, and psychologists to meet patients’ needs [ 101 , 104 ] and ensure continuity of care [ 105 ].…”
Background
Inflammatory bowel diseases (IBD) are remitting and relapsing diseases that mainly interest the gastrointestinal tract. IBD is associated with a condition of psycho-social discomfort that deeply compromises the quality of life and the competence of patient to be fully engaged in their self-management. As a consequence, effective care of IBD patients should include not only medical but also psychological support in order to improve patients' wellbeing. Although this, to date there is no standardized approach to promote psychological wellbeing of IBD patients in order to improve the perception of the quality of the care. To fill this gap, a consensus conference has been organized in order to define the psychosocial needs of IBD patients and to promote their engagement in daily clinical practice. This paper describes the process implemented and illustrates the recommendations deriving from it, which focus on the importance of a multidisciplinary approach in IBD management.
Results
The consensus conference has been organized in three phases: (1) literature review about life experiences, engagement, and psychosocial needs of IBD patients; (2) workshops with IBD experts and patients’ representatives; (3) drafting of statements and voting. Seventy-three participants were involved in the consensus conference, and sixteen statements have been voted and approved during the consensus process.
Conclusions
The main conclusion is the necessity of the early detection of – and, in case of need, intervention on- psycho-social needs of patients in order to achieve patient involvement in IBD care.
“…Patients want to take part in decisions regarding their treatment and to contribute actively in optimizing the effect of treatment. For example, those with diabetes learn self-management through blood glucose monitoring [22, 23], those with chronic obstructive pulmonary disease learn how to use an inhaler [24], and those with inflammatory bowel disease learn how to monitor for an upcoming outbreak and when to start medication [25].…”
Background
Condom use can reduce the risk of infection by human papillomavirus (HPV). Furthermore, it has been suggested that condom use can increase the regression rate of cervical lesions. In Denmark, women with cervical intraepithelial neoplasia grade 2 (CIN2) and a future wish to conceive are not treated immediately but are followed up by a gynecologist about 6 months later. The aim of this project was to determine if advising women to have their male partners to use a condom during sexual intercourse in the follow-up period can increase the regression rate of CIN2.
Methods/design
This is a randomized clinical trial of women with CIN2. The intervention group was advised to use condoms between the date of diagnosis and the date of their follow-up visit. The control group received standard care. Cervical samples were tested for HPV. The primary endpoint will be the intention-to-treat analysis with the relative rate of CIN2 regression between the intervention group and the control group. Regression is defined as
“…Communication among members of this multidisciplinary team is essential to ensure timeliness of escalation in medication, admission when required and management of surgical complications . Self‐monitoring by patients shows considerable promise, particularly when coupled with central monitoring of changes in their disease state .…”
Section: General Principles In Ibd Surgerymentioning
Aim
There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology.
Methods
Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines.
Results
All aspects of surgical care for IBD have been included along with 157 recommendations for management.
Conclusion
These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
