Prasad Sharmila S, Potter Michael, Keely Simon, Talley Nicholas J, Walker Marjorie M, Kairuz Therése
Faculty of Health and Medicine, School of Biomedical Science and Pharmacy University of Newcastle Callaghan New South Wales Australia.
Priority Research Centre, Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights New South Wales Australia.
JGH Open. 2019 Aug 27;4(2):221-229. doi: 10.1002/jgh3.12235. eCollection 2020 Apr.
Inflammatory bowel disease (IBD) refers to a group of complex and chronic conditions that requires long-term care delivered by a group of healthcare professionals through a multidisciplinary care model. We conducted a systematic review to examine and understand the role of healthcare professionals in the primary care management of IBD, and identify the gaps in IBD management that could be filled by primary care providers such as general practitioners (GPs) and pharmacists.
The search strategy retrieved published studies from five databases, and eligible articles were assessed for quality. A gray literature search of the websites of organizations was also undertaken.
Twenty-one studies were included, of which 19 were peer-reviewed research articles and two reports were from organizational bodies. Although studies have shown the roles of GPs, pharmacists, dietitians, and psychologists in IBD management, nurses and gastroenterologists were the key drivers delivering specialized care to IBD patients. Many key services are accessible only for hospital inpatients (tertiary care) or through outpatient clinics (secondary care) with an absence of a multidisciplinary approach including GPs and pharmacists.
Gastroenterologists and nurses have an important role in the delivery of care to patients with chronic gastrointestinal diseases including IBD, coeliac disease, irritable bowel syndrome, and functional dyspepsia. The role of nurses includes provision of specialized care to IBD patients, as well as supportive care such as education, monitoring of therapy, and ongoing assistance. The available evidence shows many opportunities for primary care providers to play a more active role in the management of IBD patients.
炎症性肠病（IBD）是一组复杂的慢性疾病，需要由一组医疗保健专业人员通过多学科护理模式提供长期护理。我们进行了一项系统综述，以研究和了解医疗保健专业人员在IBD初级护理管理中的作用，并确定IBD管理中可由全科医生（GPs）和药剂师等初级护理提供者填补的差距。
检索策略从五个数据库中检索已发表的研究，并对符合条件的文章进行质量评估。还对各组织网站进行了灰色文献搜索。
纳入了21项研究，其中19项是同行评审的研究文章，两项报告来自组织机构。尽管研究表明全科医生、药剂师、营养师和心理学家在IBD管理中的作用，但护士和胃肠病学家是为IBD患者提供专科护理的关键驱动因素。许多关键服务仅适用于住院患者（三级护理）或通过门诊诊所（二级护理）提供，缺乏包括全科医生和药剂师在内的多学科方法。
胃肠病学家和护士在为包括IBD、乳糜泻、肠易激综合征和功能性消化不良在内的慢性胃肠疾病患者提供护理方面发挥着重要作用。护士的职责包括为IBD患者提供专科护理，以及教育、治疗监测和持续协助等支持性护理。现有证据表明，初级护理提供者在IBD患者管理中发挥更积极作用的机会很多。
