Greveson Kay, Shepherd Thomas, Mulligan John P, Hamilton Mark, Woodward Sue, Norton Christine, Murray Charles
Royal Free Hospital NHS Foundation Trust Centre of Gastroenterology, London, UK.
Florence Nightingale Faculty of Nursing and Midwifery, Kings College London, London, UK.
Frontline Gastroenterol. 2016 Jan;7(1):60-65. doi: 10.1136/flgastro-2014-100548. Epub 2015 Apr 22.
Foreign travel for people with inflammatory bowel disease (IBD) carries an increased risk of travel-related morbidity. There is limited research looking specifically at travel-associated health risks and travel preparation in patients with IBD. The aims of this study are to explore the experience of travel, pretravel preparation undertaken by the patient with IBD and examine IBD healthcare professionals' (HCP) confidence at providing travel advice and the content of that advice.
A survey of patients with IBD attending an outpatient clinic with a separate online survey sent to IBD HCPs recruited using regional and international network databases.
A total of 132 patients with IBD, Crohn's disease (67/132, 51%), male (60/132, 45%) and 128 HCPs (IBD nurse specialist 113, 88%; IBD physician 15, 12%) completed the questionnaires. IBD affected travel to some extent in 62% (82/132) of patients, and 64% (84/132) had experienced an IBD flare, of whom 64% still travelled overseas during this time. Only 23% (31/132) travellers sought pretravel medical advice and 40% (53/132) obtained travel insurance. Forty-eight per cent of respondents on immunomodulator therapy were unaware of the need to avoid live vaccines. Twenty-seven per cent (34/128) of IBD HCPs are not confident at providing pretravel advice; vaccination advice (54%), obtaining travel insurance (61%) and healthcare abroad (78%) are the areas of most uncertainty.
Patients do not seek adequate pretravel advice and consultations for those who do are often deficient. The majority of IBD professionals are not confident to provide comprehensive travel advice. Greater IBD-specific travel education and awareness is needed for both patients with IBD and professionals.
炎症性肠病(IBD)患者出国旅行会增加与旅行相关的发病风险。专门针对IBD患者旅行相关健康风险及旅行准备的研究有限。本研究旨在探讨IBD患者的旅行经历、旅行前准备情况,并考察IBD医疗保健专业人员(HCP)提供旅行建议的信心及建议内容。
对一家门诊的IBD患者进行调查,并通过区域和国际网络数据库招募IBD HCP,向其发送单独的在线调查问卷。
共有132例IBD患者(克罗恩病67例/132例,占51%;男性60例/132例,占45%)和128名HCP(IBD护士专家113名,占88%;IBD医生15名,占12%)完成了问卷。62%(82/132)的患者表示IBD在一定程度上影响了旅行,64%(84/132)的患者经历过IBD发作,其中64%在此期间仍出国旅行。只有23%(31/132)的旅行者寻求旅行前医疗建议,40%(53/132)的旅行者购买了旅行保险。接受免疫调节剂治疗的受访者中,48%不知道需要避免接种活疫苗。27%(34/128)的IBD HCP对提供旅行前建议没有信心;疫苗接种建议(54%)、购买旅行保险(61%)和国外医疗保健(78%)是最不确定的领域。
患者没有寻求足够的旅行前建议,而寻求建议的患者所获建议往往不足。大多数IBD专业人员没有信心提供全面的旅行建议。IBD患者和专业人员都需要更多针对IBD的旅行教育和意识。