Adherence to clinical and endoscopic standards of quality in inflammatory bowel disease: a nationwide survey from the Italian Association of Hospital Gastroenterologists and Endoscopists.

Abstract

Objective: Quality of care in inflammatory bowel disease (IBD) patients is a major priority as it is associated with better outcomes. We assessed the adherence of Italian gastroenterologists to current international recommendations regarding quality performance measures for clinical and endoscopic IBD activities.

Methods: From March to July 2023, 179 Italian specialists participated in an online questionnaire-based survey concerning their demographic details, affiliations, clinical, and endoscopic practice. Data on the characteristics of the specialists' centres were also collected. Recommendations from European Crohn's and Colitis Organisation, Building Resources and Research in IBD Globally group, and European Society of Gastrointestinal Endoscopy for clinical and endoscopic standards were used as reference standards.

Results: Deviations from guidelines' recommendations included suboptimal availability of all specialties required for multidisciplinary teams, underuse of maintenance treatment with oral mesalamine in ulcerative colitis but still frequent use in Crohn's disease, suboptimal dosages of topical therapy, low attention to performing ileal biopsies in suspected IBD and to Paris and mucosal pattern classifications for lesion characterisation. No significant regional differences were observed, while significantly lower performances were reported for many responses coming from small centres or doctors less dedicated to IBD care.

Conclusion: In Italy, adherence to current standards of care for IBD is generally good, with some practices to be improved. There is a need to support small centres and doctors less engaged in IBD within integrated clinical care networks.