Singh Arshdeep, Bhardwaj Arshia, Sharma Riya, Midha Vandana, Sood Ajit
Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab 141001, India.
Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab 141001, India.
EClinicalMedicine. 2025 Apr 24;83:103218. doi: 10.1016/j.eclinm.2025.103218. eCollection 2025 May.
The global burden of inflammatory bowel disease (IBD) is progressively increasing, with a particularly sharp rise in newly industrialized and resource-limited settings. These regions face unique and pressing challenges in IBD care, including a shortage of trained specialists, delayed or missed diagnoses, financial and geographic barriers to access, and the persistent stigma surrounding the disease. Furthermore, cultural dynamics; especially the prominent role of family in healthcare decisions; profoundly influence patient engagement, treatment adherence, and overall outcomes. However, current healthcare models and global guidelines are largely shaped by Western systems that prioritize individual patient autonomy and may not fully align with the sociocultural realities of resource-limited settings. This viewpoint aims to highlight the need for culturally contextualized, scalable solutions to improve IBD care. Specifically, we propose the development and integration of IBD counsellors as a novel and pragmatic approach to bridge existing gaps in care. These counsellors, trained in the nuances of IBD and sensitive to local sociocultural norms, can serve as critical intermediaries; facilitating communication among patients, families, and providers; supporting adherence and follow-up; and offering tailored psychosocial and dietary guidance. By presenting this model, we seek to stimulate discourse around innovative, culturally adaptive strategies and advocate for policy-level recognition and investment to promote health equity in IBD care globally.
炎症性肠病(IBD)的全球负担正在逐步增加,在新兴工业化国家和资源有限的地区增长尤为显著。这些地区在IBD护理方面面临独特且紧迫的挑战,包括训练有素的专科医生短缺、诊断延迟或漏诊、获取医疗服务的经济和地理障碍,以及围绕该疾病的持续污名化。此外,文化因素,尤其是家庭在医疗决策中所起的重要作用,深刻影响着患者的参与度、治疗依从性和总体治疗效果。然而,当前的医疗模式和全球指南在很大程度上是由优先考虑个体患者自主权的西方体系塑造的,可能与资源有限地区的社会文化现实不完全契合。这一观点旨在强调需要有文化背景、可扩展的解决方案来改善IBD护理。具体而言,我们建议开发并整合IBD顾问,作为一种新颖且务实的方法来弥合现有的护理差距。这些顾问接受过IBD细微之处的培训,并对当地社会文化规范敏感,可充当关键的中间人,促进患者、家庭和医疗服务提供者之间的沟通,支持治疗依从性和随访,并提供量身定制的心理社会和饮食指导。通过提出这一模式,我们旨在激发围绕创新的、具有文化适应性策略的讨论,并倡导政策层面的认可和投资,以促进全球IBD护理中的健康公平。