Multidisciplinary care improves functional GI symptoms
SAN DIEGO — Patients with functional gastrointestinal disorders who underwent 3-month multidisciplinary treatment experienced superior symptom improvement compared with patients who only saw a gastroenterologist, according to data presented at Digestive Disease Week.
Gerald J. Holtmann, MD, PhD, of the University of Queensland in Australia, said that functional disorders, like irritable bowel syndrome, present difficulties for physicians, the health care system, and particularly for patients.
“Their quality of life is severely impacted,” he said in his presentation. “We need to be mindful there’s increase morbidity and mortality, not from the condition, but there are problems because of all of the futile tests and interventions which are applied actually can do harm.”
To test the efficacy of a multidisciplinary care approach, researchers recruited 35 patients (mean age 41.3 years, 81% women) with a severe manifestation of a FGID — defined as having symptoms for more than 3 years that impaired quality of life and did not sufficiently respond to previous conventional therapy — and matched them to 35 control patients with a non-severe FGID.
Patients with a severe FGID underwent a standardized assessment and treatment sessions with a GI, general practitioner, psychologist, dietitian and exercise physiologist. Controls received standard care by a GI.
The primary outcome of the study was change in number of items scored moderate and above on the Structured Assessment of Gastrointestinal Symptoms (SAGIS) scale, which is a measurement of 22 GI symptoms scored on a scale of 0 to 4.
Patients in the study had a primary diagnosis of IBS (54.3%), functional dyspepsia (11.4%) or both (34.4%).
Patients in the multidisciplinary care group saw the number of SAGIS items scored moderate and above decrease by 48% compared with a 6% decrease in the control group (P = .001). They also experienced a 36% decrease in total SAGIS score compared with 8% in the control group (P = .001). Additionally, 57% made clinically significant reductions in SAGIS scale compared with 23% in the control group.
Holtmann said their findings showed that an integrated care approach is superior to a standard model of care for patients with severe FGID manifestations.
“However, this is a starting point, and future prospective, randomized clinical trials are required to determine the relative contributions and the doses of the various components required to achieve optimal outcomes and to determine the cost-efficiency of this approach,” he said. – by Alex Young
Bray N, et al. Abstract 273. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Holtmann reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.