IBD Toolkit Interview with Dr Kevin Barrett

IBD Toolkit Update Provides Support to GPs Managing IBD Flares

Interview with Dr Kevin Barrett,

Chair of the Primary Care Society for Gastroenterology

‘We all know that IBD can be a very challenging condition to manage, particularly in a non-specialist setting,’ says Dr Barrett. ‘The RCGP IBD Toolkit was created to provide GPs with a support system that would allow them navigate the diagnostic and treatment pathways with confidence.

‘Two years on, the feedback surveys have also been very useful in identifying the areas in which GPs felt confident but also where they felt they had some gaps in their knowledge. For example, whilst most GPs (89%) felt confident in recognising IBD only 52% said that were confident that they would be able to effectively manage a patient flare up.

‘This is particularly relevant at a time when there is a growing expectation that non-complex IBD cases should be managed in primary rather than secondary care. However, it is estimated that 50% of all IBD patients will experience a flare up at least once a year and we also know that flare ups, if not managed properly, can result in hospital admissions and possibly surgery, which is of course expensive for the NHS and the patient.’

As part of the update, the IBD Toolkit now includes the recently developed pathways for the diagnosis and treatment of both Ulcerative Colitis and Crohn’s Disease flares. Information on the pathways include clarification on when to discuss or refer patients to specialist centres and advice on the type of steroid to use during flare ups. Also included are references and links to the new IBD-UK Standards which highlight Flare Management as a priority.

However, as Kevin points out, the IBD Toolkit is not simply a guide to clinical management of the disease. He believes that one of the most significant sections of the toolkit is the area which highlights the psychological and emotional costs of living with IBD, and the significance of an effective and joined-up care teams to help patients access good support rapidly, when needed.

As many of those living with IBD are under 25 the toolkit also provides updated information on age relevant topics such as pregnancy and contraception.

‘Providing good IBD care is no longer just about medically managing the condition,’ explains Kevin. ‘IBD is a lifelong disease that affects every aspect of a patient’s life, their self-esteem, work and social life and even their relationships. Ideally this should be at the forefront of every treatment decision the doctor makes.

‘For example, many of the drugs prescribed for IBD have unpleasant side effects and we know that when that happens some patients will have poor adherence which in turn can lead to dangerous and expensive flare ups. It makes sense therefore to listen to the patient and consider drugs which may have a lesser burden of side effects.

‘There is strong evidence that the more involved and activated a patient is in their treatment, the shorter their hospital stays. Overall, we hope that the IBD Toolkit will encourage GPs to consider a more holistic approach to their IBD patient. With the right support and good communication with the patient means that they are more likely to be able to effectively self-manage their condition over the long term.’