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Nutrition education needed for IBD patients, health care providers
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A recent survey study conducted by the Crohn’s and Colitis Foundation of America found significant knowledge gaps among both patients and health care providers regarding the role of nutrition in inflammatory bowel disease, highlighting the need for improved education and access to nutrition services.
“Malnutrition is common in IBD patients yet little is known about best practices for nutritional assessment and management in IBD care,” Caroline Hwang, MD, a gastroenterologist at the University of Southern California’s Digestive Health Center, and the CCFA’s nutrition project lead, said in a press release. “To better understand the role nutrition plays in IBD management, we set out to evaluate knowledge, attitudes, and beliefs regarding nutrition among IBD patients and care providers.”
Caroline Hwang
Hwang and colleagues emailed invitations to an online survey to patients, physicians, nurses, nurse practitioners and registered dietitians, all of whom were CCFA members.
The patient survey included 13 questions on demographic and disease characterization, general nutrition knowledge, perceived importance of nutrition, malnutrition criteria and interactions with health care providers regarding nutrition and nutrition resources.
The provider survey included 14 questions on demographics and practice characteristics, general nutrition knowledge, perceived importance of nutrition, nutritional assessment practices, patient interactions regarding nutrition and use of nutritional resources.
CCFA chapters in New York, Chicago and Seattle conducted focus groups involving patients and providers to explore nutrition-related themes.
Overall, 223 health care providers responded, 65.5% of whom were gastroenterologists, 15.2% nurses and 6.7% dietitians. Only 16.1% of nurses rated their knowledge of IBD-related nutrition as “very good” compared with 41.1% of gastroenterologists and 86.7% of dietitians (P < .001).
In addition, about a third of both gastroenterologists and dietitians reported they did not routinely screen their IBD patients for malnutrition, and “less than half of all providers ... felt they had access to adequate nutritional care resources to help initiate and guide discussion with their IBD patients,” the researchers wrote.
Among the 567 patients who responded (73% women, 52% aged older than 45 years), 27% rated their knowledge of IBD-related nutrition as “very good,” and patients with Crohn’s disease were more likely to report having “very good” knowledge of nutrition compared with ulcerative colitis patients (P = .006).
While 58.5% of patients reported that nutrition was “very important” in IBD management (90.2% of Crohn’s patients vs. 84.1% of UC patients; P = .028), just 36% reported talking with a health care provider about nutrition routinely.
The 14 patients and 23 providers who participated in the focus groups reported that nutrition is important in IBD management, and “many physicians admitted that they probably do not screen for malnutrition frequently enough and therefore miss opportunities to intervene early in malnourished IBD patients,” the researchers wrote. The focus groups also indicated there is a knowledge gap among providers, and that sufficient IBD-related nutrition resources are lacking.
“In addition to targeted educational initiatives and the development of appropriate nutritional resources, nutrition specialists should be integrated into the multidisciplinary IBD care team, and access and affordability to qualified nutrition services desperately need to be improved,” the researchers concluded.
In light of these findings, the CCFA will launch a Healthy Nourishment in IBD Program within its quality of care initiative, IBD Qorus, according to a press release. This effort includes development of a Nutritional Care Pathway that will provide validated tools for identifying and evaluating malnourished patients or those at risk for malnutrition, as well as educational tools for preventing and treating malnutrition.
“The learnings from this study reinforce the importance of creating programs around nutrition to optimize the quality of life and outcomes of patients with IBD,” Alandra Weaver, MPH, director of IBD Qorus, said in the press release. – by Adam Leitenberger
Disclosures: This study was funded by Nestlé Health Science. The researchers report no relevant financial disclosures.
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