Background and aimsForeign travel for people with inflammatory bowel disease (IBD) carries an increased risk of travel-related morbidity. There is limited research looking specifically at travel-associated health risks and travel preparation in patients with IBD. The aims of this study are to explore the experience of travel, pretravel preparation undertaken by the patient with IBD and examine IBD healthcare professionals’ (HCP) confidence at providing travel advice and the content of that advice.MethodsA survey of patients with IBD attending an outpatient clinic with a separate online survey sent to IBD HCPs recruited using regional and international network databases.ResultsA total of 132 patients with IBD, Crohn's disease (67/132, 51%), male (60/132, 45%) and 128 HCPs (IBD nurse specialist 113, 88%; IBD physician 15, 12%) completed the questionnaires. IBD affected travel to some extent in 62% (82/132) of patients, and 64% (84/132) had experienced an IBD flare, of whom 64% still travelled overseas during this time. Only 23% (31/132) travellers sought pretravel medical advice and 40% (53/132) obtained travel insurance. Forty-eight per cent of respondents on immunomodulator therapy were unaware of the need to avoid live vaccines. Twenty-seven per cent (34/128) of IBD HCPs are not confident at providing pretravel advice; vaccination advice (54%), obtaining travel insurance (61%) and healthcare abroad (78%) are the areas of most uncertainty.ConclusionsPatients do not seek adequate pretravel advice and consultations for those who do are often deficient. The majority of IBD professionals are not confident to provide comprehensive travel advice. Greater IBD-specific travel education and awareness is needed for both patients with IBD and professionals.
were abnormal liver tests [predominantly transaminitis] (n = 11); myelosupression (n = 6). Six patients were admitted to hospital [myelosuppression n = 2, pancreatitis n = 1, unrelated to IMD n = 3]. Management of adverse events included changing to an alternative agent (n = 13), dose adjustment (n = 12) and discontinuation of IMD (n = 10). Conclusion A pharmacist-led clinic is a safe alternative to conventional gastroenterology clinics for monitoring of patients on IMD. Adverse events were picked up early and adequately acted upon. There was a high level of patient compliance and reduced number of clinic visits; the average numbers of clinic visits saved were 10 per patient. Introduction The internet offers a wealth of information for patients with chronic disease, facilitating education and shared decision making; however, this can often be unregulated and inaccurate.
REFERENCES1 Inflammatory bowel disease (IBD) patients use of the internet has been investigated 2 but no studies have examined whether internet use alters with disease activity or influences patients decisions regarding health. We evaluated patients internet use for health-related information (HRI), including factors influencing website choice and whether this information influences decisions regarding healthcare or changes with disease severity. Methods A prospective, pilot survey of 170 consecutive patients attending the IBD clinic over a one month period in November 2013. The anonymous questionnaire included demographic information on age, gender, education level, diagnosis and disease activity. There were also questions regarding use of the internet for HRI, determinants of website quality and influences of information found on the internet on decisions affecting their health. Results A total of 136 IBD patients completed the questionnaire (80% response rate), 60 [44%] male, age 18-85 years [median age 37 years] 67 [49%] had CD; 84 [62%] reported a flare of symptoms in the preceding 6 months. 126 (93%) use the internet, 110 (81%) of which access HRI information via the internet. 94% of patients were educated to completion of high school or above and level of education did not affect internet use. Using NHS direct (46%), Crohn's and colitis UK (40%) and IBD forums (29%), patients searched for general health (77; 57%); IBD specific (63; 46%) and medication (47; 35%) information. 45 (33%) stated that information found on the internet would influence their choice of medication, irrespective of a flare within the last 6 months. 71% (96) felt confident that they could obtain factual information on the internet, although when determining website quality, overall appearance and position in search engines and whether the site was non-commercial were ranked least important and IBD-specific sites from a reputable source most important. Conclusion In our study, internet use is shown to be a major source of disease -specific information and can affect patients' decision making. Internet usage and type of information sought do not alter with disease activi...
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