Health-related quality of life in inflammatory bowel disease: a comparison of patients receiving nurse-led versus conventional follow-up care.

Health-related quality of life IBD nurse specialist Inflammatory Bowel Disease Questionnaire Inflammatory bowel disease Micro-team Multidisciplinary team Quality of Life Quality of care

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
31 Dec 2022
Historique:
received: 07 05 2022
accepted: 19 12 2022
entrez: 31 12 2022
pubmed: 1 1 2023
medline: 4 1 2023
Statut: epublish

Résumé

Inflammatory bowel disease (IBD), consisting of Crohn's disease (CD) and ulcerative colitis (UC), is a chronic disorder with a considerable negative impact on health-related quality of life (HRQoL). During the past decade, IBD nurse specialists have been increasingly involved in follow-up care of IBD outpatients, in a consultative and coordinating role, closely cooperating with gastroenterologists. Whether patients' HRQoL differs between nurses' follow-up care (NF) and conventional follow-up care (CF) has not been widely researched and the aim of this study was to compare two different follow-up regimes with respect to patients' HRQoL. This cross-sectional, multicenter study involved seven centers; five organized as CF, two as NF. A total of 304 patients aged 18-80 years, 174 females and 130 males, were included, of whom 140 received care under the NF model and 164 under the CF model. Participants in the NF group had a statistically significant higher median total score on the Inflammatory Bowel Disease Questionnaire (IBDQ) (p-value < .001). This pattern could also be seen in the sub-scores of the different IBDQ domains. Despite a trend of higher IBDQ score in all domains in the NF model, the overall result in our study did not reach the limit of 16 points, defined as clinically significant. A higher proportion of NF patients had IBDQ scores defined as remission, as well as a statistically significant higher frequency of outpatient check-ups during a two-year follow-up period. Nurse-led models are not inferior to conventional models with regards to patient reported HRQoL except in the social domain where the model showed to be clinically significant better. Further studies are needed to advance efforts to implement these models and increase access to IBD care.

Sections du résumé

BACKGROUND BACKGROUND
Inflammatory bowel disease (IBD), consisting of Crohn's disease (CD) and ulcerative colitis (UC), is a chronic disorder with a considerable negative impact on health-related quality of life (HRQoL). During the past decade, IBD nurse specialists have been increasingly involved in follow-up care of IBD outpatients, in a consultative and coordinating role, closely cooperating with gastroenterologists. Whether patients' HRQoL differs between nurses' follow-up care (NF) and conventional follow-up care (CF) has not been widely researched and the aim of this study was to compare two different follow-up regimes with respect to patients' HRQoL.
METHODS METHODS
This cross-sectional, multicenter study involved seven centers; five organized as CF, two as NF.
RESULTS RESULTS
A total of 304 patients aged 18-80 years, 174 females and 130 males, were included, of whom 140 received care under the NF model and 164 under the CF model. Participants in the NF group had a statistically significant higher median total score on the Inflammatory Bowel Disease Questionnaire (IBDQ) (p-value < .001). This pattern could also be seen in the sub-scores of the different IBDQ domains. Despite a trend of higher IBDQ score in all domains in the NF model, the overall result in our study did not reach the limit of 16 points, defined as clinically significant. A higher proportion of NF patients had IBDQ scores defined as remission, as well as a statistically significant higher frequency of outpatient check-ups during a two-year follow-up period.
CONCLUSIONS CONCLUSIONS
Nurse-led models are not inferior to conventional models with regards to patient reported HRQoL except in the social domain where the model showed to be clinically significant better. Further studies are needed to advance efforts to implement these models and increase access to IBD care.

Identifiants

pubmed: 36587197
doi: 10.1186/s12913-022-08985-1
pii: 10.1186/s12913-022-08985-1
pmc: PMC9805028
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1602

Informations de copyright

© 2022. The Author(s).

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Auteurs

Line Alvestad (L)

UiT, The Arctic University of Norway, Tromsø, Norway. line.alvestad@unn.no.
University Hospital of North Norway, UNN Harstad, Tromsø, Norway. line.alvestad@unn.no.

Lars-Petter Jelsness-Jørgensen (LP)

Østfold University College, Fredrikstad, Norway.
Department of Gastroenterology, Østfold Hospital Trust, Kalnes, Norway.

Rasmus Goll (R)

University Hospital of North Norway, UNN Harstad, Tromsø, Norway.
UiT, The Arctic University of Norway, Tromsø, Norway.

Anne Clancy (A)

UiT, The Arctic University of Norway, Tromsø, Norway.

Thomas Gressnes (T)

UiT, The Arctic University of Norway, Tromsø, Norway.

Per Christian Valle (PC)

University Hospital of North Norway, UNN Harstad, Tromsø, Norway.

Ann Ragnhild Broderstad (AR)

University Hospital of North Norway, UNN Harstad, Tromsø, Norway.
UiT, The Arctic University of Norway, Tromsø, Norway.

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