Assessing Inflammatory Bowel Disease Care Quality in Portugal: A Nationwide Gastroenterologist Survey

Inflammatory bowel disease (IBD) care demands a multidisciplinary approach and adherence to quality indicators to optimize patient outcomes. This study aimed to evaluate the structure and quality of IBD care in Portugal, exploring the perceptions of gastroenterologists and identifying areas for improvement.

A cross-sectional online survey was conducted among Portuguese gastroenterologists between January and February 2024. The questionnaire assessed IBD care organization, processes and perceptions regarding quality indicators. Responses from 57 participants were analyzed using descriptive and inferential statistics.

Most participants (74%) work in public hospitals, with 89.5% providing specialized IBD consultations. Multidisciplinary teams are present in 58% of the participants' centers. In addition to gastroenterologists, IBD multidisciplinary teams include mostly surgeons (88%) and radiologists (62%). Waiting times for nonurgent IBD-specific consultations varied, with 61% of the respondents reporting delays exceeding 1 month. More than two-thirds reported waiting times for nonurgent endoscopic and cross-sectional exams longer than 3 months. Psychological and nutritional assessments were underprioritized, with only 6% and 37% of centers routinely performing these evaluations, respectively. Only 42% of participants answered that their centers keep updated patient registries and 16% used quality indicators known to all team members. Most responders (76%) reported research activity in their units, mainly through national multicenter (88.1%) and observational studies (71%). Units with multidisciplinary teams were significantly more likely to follow structured protocols, provide timely care, and adopt advanced diagnostic tools. Most participants acknowledge the importance of quality indicators, classifying them as mandatory or relevant, with 96% supporting the auditing of IBD centers.

This study highlights strengths in the Portuguese IBD care, including multidisciplinary collaboration, research engagement, and widespread awareness of quality indicators. However, challenges remain, such as delays in specialized IBD consultations, endoscopic and cross-sectional exams, and inadequate scheduling for other consultations. Moreover, gaps persist in integrating psychological and nutritional care and maintaining updated patient registries. Expanding multidisciplinary teams and strengthening quality monitoring are critical for improving care outcomes for Portuguese IBD patients.