The one-page pathways are designed to assist GPs in supporting patients with established, uncomplicated inflammatory bowel disease. They have been developed by the RCGP and Crohn's & Colitis UK IBD Spotlight Project and endorsed by the British Society for Gastroenterology, the Primary Care Society for Gastroenterology and the RCGP.
GPs are often the first port of call for patients having a suspected flare, yet 52% are less than confident or not confident in managing flares, according to a survey of 525 GPs and GP trainees carried out in April 2017 by the RCGP and Crohn's & Colitis UK IBD Spotlight Project.
To address this, a group of patients, GPs, IBD clinical nurse specialists and gastroenterologists was convened to develop pathways based on NICE, BNF, and European Crohn's and Colitis Organisation (ECCO) guidance.
The new flare pathways aim to give both GPs and patients the confidence to know what to do when in a flare.
The pathways provide advice on the assessment of flare severity using established criteria, warnings when patients may be becoming septic, when to seek input from secondary care, investigations to carry out in primary care, initial medication changes or escalation, when to assess response to treatment, and when to revert to the baseline treatment regime.
Dr Kevin Barrett, Clinical Champion for the RCGP and Crohn's & Colitis UK IBD Spotlight Project, who led the creation of the resources, said, 'These pathways have been co-created with patients, GPs, IBD nurse specialists and gastroenterologists, and, with the endorsement from three key organisations, they are a credible resource that we hope primary care professionals will start using immediately.'
The RCGP and Crohn's & Colitis UK IBD Spotlight Project was launched in 2017 to increase awareness of Crohn's disease and ulcerative colitis and provide advice on carrying out initial investigations and referring patients appropriately to secondary care. The project is now focusing on flare management and supporting GPs to manage the disease in the long-term.
MIMS publishes similar quick-reference one-page guides to the management of Crohn's disease and ulcerative colitis, which summarise the recently updated NICE guidance on these conditions.