N18 Multidisciplinary team importance in the view of the patients with Inflammatory Bowel Disease in Brazil
Herrerias, G.(1);Ribeiro, J.R.(1);Beraldo, R.F.(1);Hossne, R.S.(1);Baima, J.P.(1);Sassaki, L.Y.(1);
(1)São Paulo State University Unesp, Department of Internal Medicine, Botucatu, Brazil
Background
Inflammatory Bowel Disease (IBD) is characterized by intestinal chronic inflammation that comprehend Crohn's disease (CD) and ulcerative colitis (UC). Continuous care is essential. Constant contact with the multidisciplinary team (MDT) and its quality of care interferes with treatment adherence and patients' quality of life (QoL). MDT must be composed by at least gastroenterologists, coloproctologists, nutritionists, nurses and psychologists. The study evaluated the importance of MDT in the patients view.
Methods
A cross-sectional, descriptive study was developed, including 94 patients from a Brazilian IBD reference center. Clinical data and the MDT relevance were evaluated. MDT importance was assessed through a questionnaire developed for the research with the answers: nothing important, unimportant, important and very important for each professional. The patients listed professionals in order of importance. QoL was assessed by IBDQ. Treatment adherence and disease knowledge were assessed by Morisky and CCKNOW questionnaires respectively.
Results
A total of 54 patients with CD and 40 with UC were included, 59.57% female and 53.19% with comorbidities. Previous hospitalization was reported by 54.26% and 36.17% were submitted by previous surgery. The majority referred previous consultation with a gastroenterologist (95.74%) and less than half with nutritionist (47.87%), IBD nurse (43.62%), psychologist (43.62%) and coloproctologist (23.40%). Gastroenterologist was considered important or very important by all patients, coloproctologist by 97.15%, IBD nurse 94.36%, endoscopist nurse 86.16%, stomatherapist 78.19%, nutritionist 88.46% and psychologist 80.55%. Regarding the order of importance, patients reported the gastroenterologist (87.50%) as the most important, followed by the coloproctologist (16.67%) and IBD nurse (14.10%). Patients with CD had more appointments with IBD nurse compared to UC patients (p = 0.007). QoL was considered excellent or good (64.51%). Drug adherence was low in 58.89% of patients. Knowledge about the disease was considered low (2.65 ± 1.65 points), being higher in patients with CD (p = 0.04).
Conclusion
Although the service has MDT, not all patients had the opportunity to visit all professionals. The lack of contact with the entire team, especially with the nurse, can reflect on low medication adherence and disease knowledge, impacting on disease control and QoL. Holistic patient care is recommended, emphasizing the importance of all professionals in the MDT for all patients with IBD.