{"id":312,"date":"2020-05-21T11:36:38","date_gmt":"2020-05-21T11:36:38","guid":{"rendered":"https:\/\/blogs.bmj.com\/fg\/?p=312"},"modified":"2020-05-21T11:36:38","modified_gmt":"2020-05-21T11:36:38","slug":"are-we-actually-providing-a-mdt-approach-to-our-ibd-patients","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/fg\/2020\/05\/21\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\/","title":{"rendered":"Are we actually providing a MDT approach to our IBD patients?"},"content":{"rendered":"
    \n
  1. Jessica Anne Eccles1<\/a>,2<\/a>,<\/li>\n
  2. Anna Ascott3<\/a>,<\/li>\n
  3. Rona McGeer4<\/a>,5<\/a>,<\/li>\n
  4. Emma Hills6<\/a>,<\/li>\n
  5. Anja St.Clair Jones6<\/a>,<\/li>\n
  6. Lisa A Page7<\/a>,<\/li>\n
  7. Melissa A Smith6<\/a>,<\/li>\n
  8. Alana Loewenberger8<\/a>,<\/li>\n
  9. Jemima Gregory7<\/a><\/li>\n<\/ol>\n

     <\/p>\n

     <\/p>\n

    On so many occasions throughout my career I\u2019ve reviewed a patient with inflammatory bowel disease where no matter what next \u201cmab\u201d I throw at them, no matter how much of their bowel is healed, there remains this void that no medical or surgical intervention can fill\u2026.I imagine for patients this must be exhausting. This poor doctor is trying their best to get me right, my bloods are normal, my endoscopy is the best it has been in years and yet I just don\u2019t feel right\u2026.whats wrong with me?<\/p>\n

     <\/p>\n

    The answer to anyone with a chronic disease or to anyone who looks after a patient with one is that it\u2019s probably wrong to think that there is something wrong with you, and important to realise that it\u2019s a perfectly normal phenomenon for a chronic disease to cause havoc with the person and psyche that makes you\u2026\u2026. you.<\/p>\n

     <\/p>\n

    That\u2019s where often as IBD clinicans it\u2019s easy to feel quite frustrated\u2026what more can I offer this patient? What more can I do? The answer I think is to take a step back, realise that this patient in front of you requires in addition to your help, a unique set of skills, that have been developed over time that can help overcome some of the psychologic trauma that the disease has caused on their lives.<\/p>\n

     <\/p>\n

    This article is an example and timely reminder to me that it is not necessarily my failure if I cannot fully \u00a0fix an IBD patient- I may be wrong but\u00a0 for some patients, I suspect having IBD may be like facing a constant army that could attack at any minute, your defences are constantly primed for a potential sneak attack. Sometimes you have your doctor who is leading you into battle but without the game plan conjured up by the help of your clear mind, the battle can easily be lost.<\/p>\n

     <\/p>\n

    Its articles like this that empower me as a doctor to try and do more outside my own expertise to help my patients. It\u2019s a reminder that problems associated with IBD can often be invisible to the naked eye but if you examine the patient with the correct lens, you see a patient who needs a different type of help from the one you are so good at providing. It\u2019s at times like these you put down the stethoscope, hold of that next endoscopy and call a friend to help you tackle this from a different angle.<\/p>\n

    To me this study highlighted the power of an integrated psychological therapy support for our IBD patients. In this study they secured funding to provide integrated psychological support for 75 patients with IBD between 2015 and 2017. What was absolutely no surprise to me ( and I\u2019m sure anyone who looks after patients with IBD), was that the psychological intervention led to reductions in IBD symptoms (\u0394SIBD; p=0.003), alongside improvements in depression scores (\u0394PHQ-9, p=0.006) and global impression (\u0394CGI; p=0.046).<\/p>\n

     <\/p>\n

    We use a lot of buzz words in medicine the \u201c multi-disciplinary team\u201d being one of my favourite words\u2026.it\u2019s so often used in IBD care but to me if we continue to ignore and not provide psychological support are we really providing patients with \u201cmulti-disciplinary care?\u201d There is a severe shortage of psychological support for not only IBD but for many chronic diseases. From an economic perspective, funding psychological services for IBD to me is a \u201cno-brainer\u201d. If you can reduce even one or two patients symptoms enough to avoid escalation in often expensive biological therapies you have saved your trust a fortune. Beyond this however, is a moral obligation\u2026.if patients with IBD benefit from psychological support surely as a nation we have to provide it? I know anecdotally this comes up as a vital gap in IBD services. I hope articles like this may influence policy makers to value psychological services so I can truly accept that I provide my patients with multi-disciplinary care.<\/p>\n

     <\/p>\n

    Please visit the whole article here:<\/p>\n

    https:\/\/fg.bmj.com\/content\/early\/2020\/04\/03\/flgastro-2019-101323<\/p>\n","protected":false},"excerpt":{"rendered":"

    Jessica Anne Eccles1,2, Anna Ascott3, Rona McGeer4,5, Emma Hills6, Anja St.Clair Jones6, Lisa A Page7, Melissa A Smith6, Alana Loewenberger8, Jemima Gregory7     On so many occasions throughout my career I\u2019ve reviewed a patient with inflammatory bowel disease where no matter what next \u201cmab\u201d I throw at them, no matter how much of their […]<\/p>\n

    Read More…<\/a><\/p>\n","protected":false},"author":308,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-312","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nAre we actually providing a MDT approach to our IBD patients? - Frontline Gastroenterology Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/fg\/2020\/05\/21\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Are we actually providing a MDT approach to our IBD patients? - Frontline Gastroenterology Blog\" \/>\n<meta property=\"og:description\" content=\"Jessica Anne Eccles1,2, Anna Ascott3, Rona McGeer4,5, Emma Hills6, Anja St.Clair Jones6, Lisa A Page7, Melissa A Smith6, Alana Loewenberger8, Jemima Gregory7     On so many occasions throughout my career I\u2019ve reviewed a patient with inflammatory bowel disease where no matter what next \u201cmab\u201d I throw at them, no matter how much of their [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/fg\/2020\/05\/21\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\/\" \/>\n<meta property=\"og:site_name\" content=\"Frontline Gastroenterology Blog\" \/>\n<meta property=\"article:published_time\" content=\"2020-05-21T11:36:38+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2020\\\/05\\\/21\\\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2020\\\/05\\\/21\\\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Are we actually providing a MDT approach to our IBD patients?\",\"datePublished\":\"2020-05-21T11:36:38+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2020\\\/05\\\/21\\\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\\\/\"},\"wordCount\":720,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/#organization\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2020\\\/05\\\/21\\\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2020\\\/05\\\/21\\\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/fg\\\/2020\\\/05\\\/21\\\/are-we-actually-providing-a-mdt-approach-to-our-ibd-patients\\\/\",\"name\":\"Are we actually providing a MDT approach to our IBD patients? 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