TBA (22W168)

The Introduction of Nurse Led Inflammatory Bowel Disease Preconception and Pregnancy Education Clinics

Author(s)

S.Gleeson, K.Sugrue, C.O'Sullivan, G.O'Sullivan, Dr M.Buckley, Dr J.O'Grady, Dr C.Moran, Dr J.McCarthy.

Department(s)/Institutions

IBD Department, Mercy University Hospital.

Introduction

The IBD centre at the Mercy University Hospital ( MUH) has a patient population of >4000 patients. Of those roughly half are women and many patients will be diagnosed during their reproductive years. Caring for this patient cohort is a challenge due to patient lack of knowledge surrounding IBD and misinformation that can occur.

Aims/Background

The primary aims of this audit was to identify the unmet education needs of patients with IBD in relation to pregnancy and improve patient education, care and outcomes through the establishment of IBD preconception and pregnancy education clinics

Method

An audit was carried out at the IBD infusion suite and Nurse led IBD clinics over a 20 week period between April- August 2021. 448 patients between the ages of 18-45 were identified during this time frame and asked to complete an IBD and pregnancy questionnaire. The questions asked were; Q1) Are you planning pregnancy in the next 2 years Q2) Has your IBD diagnosis affected your family planning in any way? Q3) Do you feel prepared/well informed from an IBD perspective to start/continue your family? Q4) Do you have any questions/concerns regarding IBD and pregnancy? Q5) What do you feel the percentage risk of your baby developing IBD would be(0-10%, 10-20%,20-40% or>40%) Q6) Would you be interested in attending a pregnancy education clinic with an Advanced Nurse Practitioner candidate?

Results

89% of respondents felt they needed more education in IBD and pregnancy. 70% of female respondents were concerned about the impact of IBD flare up on fetal health with 19% remaining voluntarily childless. 95% had concerns about use of biologic drugs in pregnancy, 90% said they would attend ANPc led preconception and pregnancy education clinics. 84% of patients overestimated the percentage risk of offspring developing IBD with 59% estimating the risk to be >20%.

Conclusions

The audit identified the need for preconception and pregnancy education clinics for patients with IBD and led to the establishment of same. This audit also identified the need for the implementation of pregnancy care pathways and the implementation of a clinical link for the service.

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