INTRODUCTION
WHY IS QUALITY OF CARE IMPORTANT IN IBD?
WHAT IS THE PROCESS OF IMPROVING QUALITY OF CARE?
HOW CAN PATIENTS HELP?
Shared decision-making in treatment decisions: This includes discussion about the choice of treatments (e.g., thiopurines, biologics or surgery) and allows more information to emerge for better decisions. There is some evidence that shared decision-making is associated with greater satisfaction and adherence in the use of biologics in rheumatoid arthritis, whereas in IBD, shared decision-making has been associated with greater satifaction and lower anxiety [10,11].
Improved communication between patients and healthcare practitioners: The patient is central to improving patient satisfaction, and communication can be facilitated by an IBD specialist nurse, educational apps or websites that feature frequently asked questions. Currently, more than 50 mobile applications related to IBD are available from 2 marketplaces, Google Play for Android and Apple’s iTunes App store [12]. These apps have potential benefits in improving quality of care in terms of patient education, remote disease monitoring, earlier intervention, improved adherence, patient empowerment, among others.
Feedback from patients in improving services in IBD care: While health outcomes may often be slow to respond to structural changes and outcome measurement can be costly and time-consuming, engaging patients in the collection of their health data may facilitate feedback on the impact of quality improvements [13]. Feedback helps drive improvement in quality, which is why the private sector (e.g., retailers, hoteliers) demand it often. Feedback can be acquired through feedback forms, surveys in IBD clinics, patient interviews, or more formalised involvement in planning structure and process improvements.
WHAT ARE THE KEY STRUCTURAL MEASURES FOR QUALITY OF CARE?
WHAT ARE THE KEY PROCESS MEASURES NEEDED TO IMPROVE QUALITY OF CARE?
WHAT IS THE ROLE OF THE PROCESS MEASURES OF CLINICAL PATHWAYS AND CHECKLISTS IN ENSURING CONSISTENCY IN CARE?
HOW CAN WE IMPROVE CLINICAL OUTCOMES THROUGH THE PROCESS MEASURES OF TIGHT MONITORING AND DISEASE CONTROL (TREATTO-TARGET)?
Clinical and patient-reported remission, defined as resolution of abdominal pain and diarrhoea or altered bowel habit (assessed at least every 3 months until resolution, then every 6 to 12 months), plus;
Endoscopic remission, defined as resolution of ulceration at ileocolonoscopy, or resolution of inflammation on crosssectional imaging, in patients who could not be assessed adequately by ileocolonoscopy (assessed at least every 6 to 9 months during active disease).
Clinical and patient-reported remission, defined as resolution of rectal bleeding and diarrhoea or altered bowel habit (assessed at least every 3 months until resolution, then every 6 to 12 months), plus;
Endoscopic remission, defined as a Mayo endoscopic subscore or UC Endoscopic Index of Severity score of 0 or 1 (assessed 3 to 6 months after starting therapy in symptomatic patients and then at least every 3 months during active disease).