In a recent audit of IBD patient care in the UK they found unacceptable variations in care. Not good for a disease that affects 1 person in 400 in the UK.
They found the following:
- 44% of sites in the UK do not have an IBD clinical nurse specialist
- Very poor provision of dietetic services not just for IBD but for gastroenterology as a whole
- Lack of adequate toilet provision in hospitals (for a condition with diarrhoea as a major feature) with a median 4.5 beds per toilet
- Less than 1 in 5 hospitals are able to refer patients directly for psychological support
- Crucial aspects of care are suboptimal; for example only 42% of patients with IBD having a stool sample sent for standard culture and for CDT (clostridium difficile toxin). Only 52% of patients admitted with CD (a disease often associated with weight loss and malnutrition) were weighed and only 37% were seen by a dietitian
- Many patients with CD are receiving inappropriately prolonged courses of steroids (46% on continuous oral therapy for more than 3 months). Prolonged use of steroid therapy is of no benefit in maintaining remission in CD, increases the risk of septic complications and is associated with an increased mortality
- There is inadequate prophylactic bone protection therapy given for patients on systemic steroids and inadequate screening for osteoporosis
- There seems to be very infrequent participation in clinical research in IBD in the UK
More info here.