Promoting psycho-social wellbeing for engaging inflammatory bowel disease patients in their care: an Italian consensus statement

Abstract

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.

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“…Co-existing mental health issues are also prevalent within the paediatric population and impact on their quality of life and compliance with treatment. 79 Graffigna et al 80 highlighted the importance of early identification and management of mental health issues in patients to ensure optimal patient engagement. Adequate medication education and training is paramount to increase compliance and limit side effects.…”

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“…Of the professions listed above, the role of a dedicated IBD psychologist seems to be the most debated one, and is often not even considered as an extended member of the MDT 101. However, as the importance of the brain-gut axis and the effect of psychological symptoms on IBD management are increasingly being recognised,80 a more recent Italian consensus statement identified psychological support as an essential component in holistic IBD care model 110. Although more evidence is needed, a prospective pilot study offering this type of integrated psychological support, not only found improvements in IBD symptoms, and psychological well-being, but also reductions in outpatient appointments and imaging 111.…”