N005 Specialist nursing interventions for inflammatory bowel disease. (16th January 2018)

• Record Type: Journal Article
• Authors: Schirato, E; Savarino, E V; Martinato, M
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S570
• Page End: S570
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.1019
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Specialist nurses are recognised to play a key role in the management and care of patients with inflammatory bowel disease (IBD). However, in medical literature, there is scant evidence in supporting the effectiveness of specialist nursing interventions. Indeed, in 2008, a Cochrane review was able to include only one low-quality trial. So far, the aim of this review was to assess if this warning influenced the rate of nursing studies published in the last years and to identify the impact of specialist nursing interventions in improving the care and management of IBD patients. Methods: Scientific articles were searched in electronic database such as Medline, Cinahl and Scopus. An hand-made searching was done to assess grey literature and congress proceedings from the major gastroenterology conferences. Studies from September 2008 and December 2016 were considered for possible inclusion. Randomised controlled trials and open-label controlled investigations were considered for inclusion. Two investigators independently extracted data and assessed trial quality. Any discrepancies were resolved by consensus. Results: Two studies were included in this literature review: one longitudinal, non-interventional study of 140 IBD patients receiving a specialist nurse-led follow-up ( n = 71) or conventional follow-up ( n = 69), with assessments every three months, and a prospective cohort controlled study, carried out immediately prior to, and after the introduction of a formal IBD Service in the hospital. These studies were both limited by study design, baseline differences between groups in the first study and impossibility to determine the nurses' specific contributions in influencing patients' outcomes in the second investigation. Furthermore, the latter study mainly focused on hospital admission length and related costs. The first study did not show significant differences between the two follow-up regimens, whereas the results of the second investigation demonstrated a more proactive care and a net saving in direct healthcare costs after a formal IBD service implementation. Conclusions: Ten years after the named Cochrane review, the lack of controlled trials aimed to demonstrated the benefit of IBD nursing is disappointing. Although specialist nursing interventions might provide benefit for IBD patients, the two included studies were of low quality and the results should be interpreted with caution. Higher quality trials of specialist nursing interventions are needed to assess their impact on the care and management of IBD patients.