IBD patients need in health quality of care ECCO consensus

Introduction: Inflammatory bowel diseases (IBD) is a lifelong disorder with increasing incidence and prevalence. IBD primarily affects young people's productivity in addition to direct and in-direct costs. The chronic nature of the disease and the patients' requirement of frequent and easy access to the Health Care providers regarding lifelong medication, social and psychological support and regular follow-up in out-patient clinics are important considerations to address. Aim and methods: To define IBD patients' needs in Quality of Health Care (QoHC) in Europe based on up-to-date available evidence. The working group consisted of doctors, nurses and patient organizations from 12 European countries and Israel. PubMed searching was performed as defined in the Delphi Method. Each recommendation was graded (RG) in accordance with level of evidence (EL) based on Evidence Based Medicine, Oxford Centre. During UEGW 2007 the group reconvened to agree on the final version for each chapter of the guideline statement. Results: Pub Med search led to 6 RCT, 7 reviews, 63 original articles, but no meta-analysis regarding "Information"; "Education"; "Primary Care", "Quality of life", "Psychological help" and "Benchmarking of Health Care systems" in IBD. Seven ECCO statements have been worked out. Conclusion: Evidence-based medicine in QoHC is limited. It is concluded that optimizing QoHC by "information"; "education", "benchmarking" and "psychological analysis" helps the patients to understand the disease and comply with their therapy, increasing QoL, reducing depression and anxiety. Future aspects regarding more evidence-based investigation and optimization of QoHC in IBD throughout Europe have been proposed. (c) 2008 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.