¿Cómo se maneja la enfermedad inflamatoria intestinal en los servicios de digestivo en España?: Resultados de la Encuesta GESTIONA-EII

espanolIntroduccion: no en todos los centros nacionales existen unidades ni especialistas dedicados a la EII. El objetivo de la SEPD fue conocer, a traves de una encuesta a sus socios, datos sobre el manejo de la EII en los servicios de digestivo de Espana. Material y metodos: encuesta en linea (telematica) realizada entre el 2 de febrero y el 9 de marzo de 2015, a socios de la SEPD (remitida a 2.017 socios numerarios con actividad clinica) divididos en tres categorias: jefes de servicio, digestivos generales y digestivos especializados en EII. Se muestran los resultados de las ultimas dos incluyendo preguntas demograficas y otras mas especificas sobre el modo y recursos con los que se cuenta para atender a estos pacientes. Resultados: se recibieron 166 encuestas completas (tasa de respuesta del 8,19%, con distribucion entre todas las CC. AA. menos La Rioja), excluyendo las de los jefes de servicio. Sesenta digestivos se consideraban expertos en EII y 106 se consideraban no expertos en EII, bien generales o especializados en otros ambitos, siendo el principal el area de endoscopias. Un 28% de los digestivos no expertos afirmaron que sus hospitales tienen unidades de EII y en un 46% existe una consulta monografica. Pero un 26% referia que ellos mismos son los que ven y tratan los pacientes de EII. Los digestivos expertos en EII refieren disponer de una estructura con recursos para desarrollar su tarea aunque existe carencia de cirujanos expertos en EII sobre todo en centros comarcales. Conclusiones: al menos 2 de cada 3 expertos en EII, socios de la SEPD parecen disponer de recursos para desarrollar su tarea (enfermeria, unidad de dia, linea telefonica, base de datos, derivacion, sesiones conjuntas). Existe ambito de mejora (correo-e para contacto con pacientes, cirujano con dedicacion especifica, ausencia de protocolos de derivacion) y 2 de cada 3 estan preocupados por el control del gasto farmaceutico. Dado que un numero de pacientes considerable sigue siendo tratado por medicos generalistas, programas para favorecer una rapida derivacion podrian ayudar. EnglishIntroduction: Not all national health centers include specialized units or clinicians devoted to inflammatory bowel disease. The goal of the survey was to gain an insight into the management of this disease within Spanish gastroenterology departments via a survey among their members. Material and methods: An online survey was conducted in February and March 2015, among SEPD members (2017 clinician members), who were split into three categories: heads of department, general gastroenterologists, and experts in this disease. The results of the last two surveys are reported, including demography-related questions and specific questions on the strategies and resources available for the care of these patients. Results: A total of 166 responses were received (response rate 8.19%), excluding those from heads of department (previously published). Sixty gastroenterologists considered themselves experts in inflammatory bowel disease, and 106 non-experts in it, the latter being either general gastroenterologists or specialists in other areas, mainly endoscopy. Twenty-eight percent of nonexpert gastroenterologists said their hospitals had specific units, with a monographic clinic in 46%. However, 26% reported that they were treating affected patients themselves. Experts in inflammatory bowel disease reported that their institute had resources to support their work, but there was a lack of surgeons with expertise in this condition, particularly in county hospitals. Conclusions: At least, within SEPD members, 2 out of 3 experts in inflammatory bowel disease seem to have the resources available for their work (nurses, day unit, telephone line, database, referrals, joint sessions). Although there is room for improvement (email to contact patients, devoted surgeon, absence of referral protocols), and 2 out of 3 are concerned about pharmacy costs. Since a substantial number of patients remain treated by general practitioners, rapid referral programs might be helpful in this setting.