Travel health and pretravel preparation in the patient with inflammatory bowel disease

Abstract

Background and aimsForeign travel for people with inflammatory bowel disease (IBD) carries an increased risk of travel-related morbidity. There is limited research looking specifically at travel-associated health risks and travel preparation in patients with IBD. The aims of this study are to explore the experience of travel, pretravel preparation undertaken by the patient with IBD and examine IBD healthcare professionals’ (HCP) confidence at providing travel advice and the content of that advice.MethodsA survey of patients with IBD attending an outpatient clinic with a separate online survey sent to IBD HCPs recruited using regional and international network databases.ResultsA total of 132 patients with IBD, Crohn's disease (67/132, 51%), male (60/132, 45%) and 128 HCPs (IBD nurse specialist 113, 88%; IBD physician 15, 12%) completed the questionnaires. IBD affected travel to some extent in 62% (82/132) of patients, and 64% (84/132) had experienced an IBD flare, of whom 64% still travelled overseas during this time. Only 23% (31/132) travellers sought pretravel medical advice and 40% (53/132) obtained travel insurance. Forty-eight per cent of respondents on immunomodulator therapy were unaware of the need to avoid live vaccines. Twenty-seven per cent (34/128) of IBD HCPs are not confident at providing pretravel advice; vaccination advice (54%), obtaining travel insurance (61%) and healthcare abroad (78%) are the areas of most uncertainty.ConclusionsPatients do not seek adequate pretravel advice and consultations for those who do are often deficient. The majority of IBD professionals are not confident to provide comprehensive travel advice. Greater IBD-specific travel education and awareness is needed for both patients with IBD and professionals.

A qualitative study of the impact of Crohn's disease from a patient's perspective

“…These included autonomy, fear of incontinence and social isolation. In addition, Pihl-Lesnovska et al 31 reported that attractiveness and intimacy are important issues for patients with CD, and Greveson et al 32 reported that travelling distances, including foreign travel, were affected by IBD. However, the present study identified far more patient-centric impacts.…”

Second N-ECCO Consensus Statements on the European Nursing Roles in Caring for Patients with Crohn’s Disease or Ulcerative Colitis

“…Pre-travel preparation and education among patients is poor with many failing to obtain any formal pre-travel advice, having inadequate travel insurance to cover IBD, and lacking awareness regarding vaccinations [326,[333][334][335]. Healthcare professionals' knowledge and provision of pre-travel counseling and adherence to international guidelines is also poor [336,337], particularly regarding avoidance of live vaccines for those on immunosuppressive medication [338][339][340].…”

Health concerns associated with travelling with inflammatory bowel disease (IBD): a questionnaire survey

“…Travel clinics do exist but travel medicine is a relatively new field which is yet to be established here in the UK. 10 Our research has shown that a considerable number of patients felt that they did not receive adequate medical advice prior to their travel. Furthermore, the vast majority of patients were interested in receiving medical advice prior to their travel abroad which reiterates that the current level of travel advice is insufficient.…”