PTH-100\u2005Gastwell: a novel, integrated health psychology service for individuals with inflammatory bowel disease

Abstract

Background Inflammatory Bowel Disease (IBD) presents challenges to psychological coping and adjustment, impacting health outcomes and disease activity. In the UK individuals with IBD have limited access to health psychology support services which can improve the quality of life and management of long-term conditions. We developed and evaluated an evidence led, integrated health psychology clinic (GastWell) within the IBD service in a large teaching hospital. Methods Anxiety, depression and illness perception data were collected from 126 patients attending an outpatient IBD nurse clinic to gain a greater understanding of the overall need for a psychological service and to assess whether the GastWell clinic is capturing all those in need of health psychology support. Specialist IBD Health Psychologists delivered brief, behaviour change focused interventions within the GastWell clinic. Following referrals from the IBD team, patients were assessed and offered assistance in adjusting to and managing their IBD, including reducing smoking and alcohol consumption. We evaluated the GastWell service using validated patient-reported outcome measures before and after intervention. Measures include the Short IBD questionnaire, Brief Illness Perceptions questionnaire and Hospital Anxiety and Depression Scale (HADs). Results 31 patients were referred to the monthly GastWell clinic between October 2016 and October 2018. The most common reason for referral was for support in adjusting to and managing IBD. Compared to the IBD population attending the outpatient IBD nurse clinic, those referred to the GastWell clinic had a more threatening view of their IBD and higher anxiety and depression scores. Patient reported outcomes suggest reductions in illness perceptions, anxiety and depression scores and an increase in health-related quality of life from pre to post intervention. Conclusion Our service evaluation suggests that those requiring health psychology support are being correctly referred into the GastWell clinic, and that the interventions are appropriate and effective in assisting patients with adjusting to and managing their IBD. In addition, we have demonstrated reductions in illness perceptions, anxiety and depression scores that are lower than the general IBD population at this site. Greater access to integrated health psychology IBD services is necessary and may benefit all individuals with IBD. *Higher score indicates higher quality of life. **Higher scores indicate a more threatening view of the illness. ***0-7 = normal; 8-10 = borderline abnormal; 11-21 = abnormal.