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ADHERENCE TO QUALITY PERFORMANCE MEASURES FOR ENDOSCOPY IN IBD: A NATIONWIDE ITALIAN SURVEY

Andrea Cassinotti 1, Ileana Maria Luppino 2, Rossella Pumpo 3, Linda Ceccarelli 4, Roberto Vassallo 5, Sergio Segato 1, Marco Soncini 6, Maria Carla Di Paolo 7

Affiliations

1 ASST Sette Laghi, Varese, Italy

2 Annunziata Hospital Cosenza, Cosenza, Italy

3 P.O. Santa Maria del Loreto Nuovo, Napoli, Italy

4 AOU Pisa, Pisa, Italy

5 Ospedale "Bucchieri la Ferla" Fatebenefratelli, Palermo, Italy

6 ASST Lecco, Lecco, Italy

7 Azienda Ospedaliera Complesso Ospedaliero San Giovanni Addolorata, Roma, Italy

Summary

AI Generated

A 2023 survey of 178 Italian gastroenterologists found generally good adherence to IBD endoscopy quality standards, with gaps in ileal biopsies during first colonoscopy and use of lesion classification systems.

Adherence to many quality measures was high: ileal intubation (97%), endoscopic activity indices (95%), post-operative Crohn's disease scheduling within 1 year (94%), and surveillance plan implementation (96%).
Performance gaps were identified in ileal biopsies during first colonoscopy for suspected IBD (67% vs 80% standard) and use of Paris (70%) and mucosal pattern (60%) classifications for lesion characterization.
Small centers (fewer than 100 IBD patients or 2 or fewer physicians) and physicians spending less than 50% of clinical time on IBD had significantly lower performance on multiple outcomes.
Younger physicians under 35 years old showed significantly higher use of modern lesion classification systems compared to older colleagues (Paris: 89% vs 68%; Kudo: 82% vs 56%).
The authors concluded that targeted support is needed for small centers and less-engaged practitioners to improve endoscopic quality in IBD care.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

The quality of gastrointestinal endoscopy in inflammatory bowel disease (IBD) patients has been recently identified as a major priority being associated with better outcomes.

Aims & Methods

We aim to assess the adherence of Italian gastroenterologists to current international recommendations on quality performance measures for IBD endoscopy.
From March to July 2023 a total of 178 Italian consultants were invited to participate to an online questionnaire-based survey, which included questions on their demographics, professional characteristics and clinical behaviour as well as structural features of their affiliations. Four clinical domains were analysed: A) the first endoscopy for suspected IBD; B) assessment of endoscopic activity; C) post-operative Crohn’s disease; and D) surveillance endoscopy for patients at high risk of colorectal neoplasia. Recommendations from three consensus on quality performance measures for IBD endoscopy (BRIDGE, ECCO, ESGE) were used as reference standards. A p value ≤0.05 was considered statistically significant.

Results

Overall, responders paid low attention to perform ileal biopsies in case of the first colonoscopy for suspected IBD (67% vs standard of care 80%) as well as to the use of the Paris (70%) and mucosal pattern classifications (60%) for lesion characterization of endoscopic visible lesions. Ileal intubation (97%) and colonic biopsies (80%) during the first colonscopy for suspected IBD, adequate tissue samples management (96%), post-operative schedule within 1 year (94%), implementation of surveillance plans (96%) and use of endoscopic index of activity (95%) were highly reported. No significant regional differences were observed, while significantly lower performances were reported for many outcomes by small centers (<100 IBD patients in follow-up and/or no more than 2 physicians for each IBD unit) or physicians spending <50% of their clinical activity for IBD. Young doctors <35 years old had a significantly higher use of modern classifications for lesion characterization (Paris: 89% vs 68%; Kudo:82% vs 56%).

Conclusion

In Italy, the adherence to current standards of care for IBD endoscopy is generally good, with some practices to be improved. There is a need to support the endoscopic activity of small centers and doctors less engaged in IBD.

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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