Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4457
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
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.
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.