Patients’ Access to Telephone and E-mail Services Provided by IBD Nurses in Canada

Abstract

Background Inflammatory bowel disease (IBD) can impact the quality of life and increase health care resource utilization. Nurses play an integral role in ensuring ease of access to care between scheduled office visits. Aims This study aimed to capture the utilization of Canadian IBD nursing telephone and e-mail services. Methods A descriptive cross-sectional study with an eight-item online survey was completed by nurses to assess the use of nurse-led telephone and e-mail services for IBD patients. Results Twenty-one IBD nurses participated, and 572 patients nurse encounters were reported. Patients with ulcerative (UC) contacted with disease flare when compared to Crohn’s disease (CD) (40% versus 24%, P < 0.001). Nursing services were primarily utilized for queries regarding medication (39.3%), disease exacerbations (29.6%), investigations (26%), and scheduling appointments (17.6%). Patients with CD had more telephone conversations (62.7%) and required more follow-up telephone calls (72.2%) compared to patients with UC (33%) and 25%, respectively. Nurse-managed interventions were provided independently for 61.4% of encounters, while 19% required a scheduled appointment in the IBD clinic. In the absence of telephone or e-mail assistance, older patients were more likely to call their family doctor (r = 0.18, P < 0.001), visit the emergency room (r = 0.18, P < 0.001), visit an urgent access clinic (r = 0.22, P < 0.001), or visit a walk-in clinic (r = 0.29, P < 0.001) than younger patients. Conclusions Nurse-managed IBD advice lines are proactive services that can address most patient disease-related concerns.

The Experiences of Older Adults Living With Inflammatory Bowel Disease

“…IBD nurses can provide advice via telephone or e-mail to persons with IBD who require access to specialist support but not necessarily requiring an appointment with a gastroenterologist (Lamb et al, 2019). Nurse-led advice lines are part of the standard of care within the United Kingdom and Australia but less often utilized in North America (Chauhan et al, 2021; Lamb et al, 2019). Both patients and IBD nurses are satisfied with nurse-led advice lines and their use has been shown to improve patient outcomes and reduce hospitalizations (Kemp et al, 2018; Leach et al, 2014).…”

Exploring the Experiences of Virtual Inflammatory Bowel Disease Care in Saskatchewan

“…Registered nurses and nurse practitioners who specialize in IBD have offered informal telephone care services for years; however, these services are not formally organized within Canada ( Chauhan et al, 2022 ). Such nurse-led VC services should become more formalized, as these providers can address most patient disease-related concerns ( Chauhan et al, 2022 ). Nurse-led VC services can decrease ever-growing wait lists, reduce health care resource utilization, and enhance access to care ( Gleeson et al, 2023 ; Karimi et al, 2021 ).…”

“…Telehealth has been used in SK to manage some conditions ( Jong et al, 2019 ), but its regular use for IBD care is limited. Globally, the literature related to the integration and assessment of IBD telephone care is limited to nurse-led telephone advice lines ( Harris et al, 2020 ), a practice not formally established in Canada ( Chauhan et al, 2022 ). To our knowledge, there is no literature on satisfaction with VC or perceived quality of IBD-related care by persons with IBD or GCPs in the SK context, and there is limited literature concerning VC use in Canada for IBD care.…”