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. 2013 Oct;4(4):296-301.
doi: 10.1136/flgastro-2013-100333. Epub 2013 Jun 28.

Inflammatory bowel disease in the UK: is quality of care improving?

Laith Alrubaiy  1 , Ian Arnott  2 , Aimee Protheroe  3 , Michael Roughton  3 , Richard Driscoll  4 , John G Williams  1
Affiliations

Inflammatory bowel disease in the UK: is quality of care improving?

Laith Alrubaiy et al. Frontline Gastroenterol. 2013 Oct.

Abstract

Objective: A national audit conducted in 2005/6 showed unacceptable quality of care for inpatients with inflammatory bowel disease (IBD) in the UK. This was re-audited in 2007/8 and 2010/11. The aim of this study is to examine the quality of care provided for inpatients with IBD in the UK.

Design: A programme of engagement and re-audit in 128 hospitals in the UK providing care for adult patients with IBD admitted to hospital between 1 June 2005 and 31 May 2006, 1 September 2007 and 31 August 2008 and 1 September 2010 and 31August 2011.

Interventions: Wide dissemination of the results, selected site visits, development of national service standards, and the development of an online document repository.

Main outcome measures: Mortality, medical and surgical treatment, specialist nursing and dietetic care were audited.

Results: Data from 1953, 2016 and 1948 patients with ulcerative colitis (UC) and 2074, 2109 and 1900 patients with Crohn's disease (CD) were audited in 2005/6, 2007/8 and 2010/11, respectively. The mortality rate fell from 1.7% to 0.8% (p=0.034) in UC and from 1.3% to 0.8% (p=0.226) in CD. The proportion of inpatients reviewed by an IBD specialist nurse has risen from 23.7% to 44.9% in UC and from 18.1% to 39.9% (p<0.001) in CD. Anti-tumour necrosis factor therapy has increased in UC and CD (p<0.001) while ciclosporin prescription has slightly fallen in UC. Laparoscopic surgeries have significantly increased in UC and CD (p<0.001).

Conclusions: The results show clear evidence of improvement in most aspects of the quality of care for IBD inpatients.

Keywords: Crohn's Disease; Health Service Research; IBD; Inflammatory Bowel Disease; Ulcerative Colitis.

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