Potential of managed care programmes for patients with inflammatory bowel diseases - results from a large survey study among physicians and IBD-patients in Germany, Austria and Switzerland (the EASE_IBDstudy)

Introduction IBD-care benefits from a multidisciplinary, cross-sectoral treatment approach and active patient involvement. However, occasionally a lack of patients´ empowerment and additionally, a necessity for the optimisation of physicians´ treatment is apparent. Furthermore, the evidence regarding the effectiveness of structured care approaches (“managed care”) on patient-related outcomes is limited. Therefore, our study aims to evaluate the potential of managed care programmes for IBD patients.

Methods EASE_IBD is a cross-border study conducted by IBD-DACH, an IBD working group in Germany (D), Austria (A) and Switzerland (Ch). Within the DACH-region, a cross-sectional survey of patients and physicians from IBD hospital-outpatient departments and gastroenterology practices was carried out. The questionnaire evaluated the effect of instruments and contextual factors of IBD-care with regard to quality of life (QoL). Additionally, the effects of “managed care” instruments were examined. The analysis was performed using a multivariate multilevel regression model, controlled by various physician and patient characteristics.

Results 2536 IBD-patients from 66 centres (643 IBD-patients/quarter; 31 % hospital out-patient departments) were consecutively enrolled in EASE_IBD (centres/IBD-pat.: D-52/1735; A-10/647; Ch-4/154). Overall, patient satisfaction (77-84 %) as well as perceived quality of care (82-87 %) was high and comparable in the descriptive analysis between German, Austrian and Swiss IBD-patients. Significant differences were only found in single characteristics, e.g. in quality of life (EQ5D-VAS; 47-64) (p = 0.004). In the entire DACH-region detectable effects of elements representing structural quality and assessments of the centres, with regard to the perceived quality of patient care, were, especially, a positive influence of web-based instruments (e.g. homepage) (p = 0.040) and potential use of homecare calprotectin (0.046).

Conclusion Our study shows that managed care programmes resulted in a high process quality, which is evident from the reported high patient satisfaction and quality of care by IBD-patients in the entire DACH region, and qualifies this area as a suitable common study landscape.

Publication History

Article published online:
01 September 2021