Implementing routine medical and mental health screening in children and adolescents with inflammatory bowel disease

Marije van Dalen1,2, Martha A C van Gaalen1, Marein M Favejee3

  • 1Department of Paediatric Gastroenterology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.

Insights

Implementing patient-reported outcome measures (PROMs) in pediatric inflammatory bowel disease (IBD) clinics is feasible. However, optimizing PROM length and frequency is crucial for better patient experience and mental health screening in IBD care.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Psychology
  • Health Services Research

Background:

  • Children with inflammatory bowel disease (IBD) often experience mental health challenges like anxiety and depression.
  • Routine mental health screening is recommended for pediatric IBD patients.
  • Patient-reported outcome measures (PROMs) can aid in monitoring symptoms and quality of life.

Purpose of the Study:

  • To describe the implementation of PROMs in a pediatric IBD outpatient clinic.
  • To assess the feasibility and user experience of integrating PROMs into routine care.
  • To evaluate the adherence and satisfaction rates with PROM usage.

Main Methods:

  • PROMs assessing anxiety, depression, fatigue, pain, and quality of life were distributed to patients (aged 8+) and parents before appointments.
  • PROMs were integrated into electronic health records.
  • A user experience survey was administered to patients who completed PROMs on at least two occasions.

Main Results:

  • 44.7% adherence rate with 175 patients/parents completing at least one PROM.
  • Most users were satisfied with the patient portal and provider discussions.
  • Some patients found the PROMs too long or too frequent; 82% reported pain/fatigue, and 20% reported anxiety/depression symptoms.

Conclusions:

  • Implementing PROMs in pediatric IBD care is feasible.
  • The length and frequency of PROMs require optimization for better patient engagement.
  • Careful selection of PROMs is essential for effective use in clinical practice.
Abstract

Related Concept Videos

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
236
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
59
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
127
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
94
Irritable Bowel Syndrome III: Medical and Nursing Management01:30

Irritable Bowel Syndrome III: Medical and Nursing Management

Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
117
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
310