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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2015; 21(15): 4457-4465
Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4457
Tools for primary care management of inflammatory bowel disease: Do they exist?
Alice L Bennett, Pia Munkholm, Jane M Andrews
Alice L Bennett, Jane M Andrews, Department of Gastroenterology, Royal Adelaide Hospital, Adelaide SA 5000, Australia
Alice L Bennett, Jane M Andrews, School of Medicine, University of Adelaide, Adelaide SA 5000, Australia
Pia Munkholm, Department of Gastroenterology, Northsealand Hospital, 1165 Copenhagen, Denmark
Author contributions: Bennett AL, Andrews JM and Munkholm P solely contributed to this paper.
Conflict-of-interest: We declare that we have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alice L Bennett, MBBS, FRACP, Department of Gastroenterology, Royal Adelaide Hospital, Level Q7, North Terrace, Adelaide SA 5000, Australia. alicebennett14@hotmail.com
Telephone: +61-8-82225207 Fax: +61-8-82222414
Received: November 25, 2014
Peer-review started: November 25, 2014
First decision: January 22, 2015
Revised: February 9, 2015
Accepted: March 12, 2015
Article in press: March 12, 2015
Published online: April 21, 2015
Processing time: 146 Days and 5.8 Hours
Abstract

Healthcare systems throughout the world continue to face emerging challenges associated with chronic disease management. Due to the likely increase in chronic conditions in the future it is now vital that cooperation and support between specialists, generalists and primary health care physicians is conducted. Inflammatory bowel disease (IBD) is one such chronic disease. Despite specialist care being essential, much IBD care could and probably should be delivered in primary care with continued collaboration between all stakeholders. Whilst most primary care physicians only have few patients currently affected by IBD in their caseload, the proportion of patients with IBD-related healthcare issues cared for in the primary care setting appears to be widespread. Data suggests however, that primary care physician’s IBD knowledge and comfort in management is suboptimal. Current treatment guidelines for IBD are helpful but they are not designed for the primary care setting. Few non-expert IBD management tools or guidelines exist compared with those used for other chronic diseases such as asthma and scant data have been published regarding the usefulness of such tools including IBD action plans and associated supportive literature. The purpose of this review is to investigate what non-specialist tools, action plans or guidelines for IBD are published in readily searchable medical literature and compare these to those which exist for other chronic conditions.

Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Guidelines; Management tools

Core tip: Much inflammatory bowel disease (IBD) care could be delivered in the outpatient setting by primary care physicians. Whilst guidelines for IBD treatment exist, they are intended to support specialist practice and are not designed to use in the primary care setting. Our systematic reviewed found that a striking paucity of IBD outpatient supportive/educational tools for primary healthcare practitioners currently exists. This is despite good evidence of acceptability and usefulness of such tools in other chronic diseases. Developing and evaluating IBD-specific tools for primary care use may improve health outcomes and reduce healthcare costs.