Multidisciplinary approach more effective for gut disorders

Date:
July 15, 2020
Source:
University of Melbourne
Summary:
Researchers have conducted a trial involving 144 patients to
compare the effectiveness of a multidisciplinary clinic - involving
gastroenterologists, dieticians, psychiatrists and physiotherapists
- with usual gastroenterology specialist-only care.



FULL STORY ========================================================================== Patients with gastrointestinal disorders -- such as irritable bowel
syndrome (IBS) and constipation -- have greater symptom relief and
improved wellbeing when treated at multidisciplinary clinics, new
research shows.


========================================================================== Researchers from the University of Melbourne and St Vincent's Hospital
have conducted a trial involving 144 patients to compare the effectiveness
of a multidisciplinary clinic -- involving gastroenterologists,
dieticians, psychiatrists and physiotherapists -- with usual
gastroenterology specialist- only care.

These patients have poorly controlled symptoms such as bloating, pain
and constipation and receive little relief from regular over-the-counter
IBS medications.

Published in the Lancet Gastroenterology and Hepatology, researchers
found 84 per cent (82 of 98) of patients in the multidisciplinary care
group achieved global symptom improvement. They reported moderate or substantial improvement in IBS symptoms such as stool frequency, pain
and bloating. This compared with 57 per cent (26 of 46) of patients in
the standard care group.

Those in the multidisciplinary group also expressed greater improvement
in psychological wellbeing, with a 40 per cent decrease in depression,
compared with a nine per cent decrease for those in standard care.

Although the average cost per patient was significantly higher in the multidisciplinary-care group, researchers found patients benefited from treatment more, indicating that the overall long-term hospital cost
would be less under this model.



========================================================================== Patients in the multidisciplinary group were also less likely to see their general practitioner for gut symptoms and were less likely to undergo
tests outside of hospital during follow-up, suggesting broad cost savings.

Researchers found patients in the multidisciplinary clinic were less
likely to take time off from work (26 per cent compared to 37 per cent
of patients in standard care), further demonstrating the value of a more holistic treatment approach.

Researchers say the findings suggest that integrated multidisciplinary
care for patients with a functional gastrointestinal disorder provides
superior symptom relief and general wellbeing, and is more cost-effective,
than traditional care.

University of Melbourne researcher and gastroenterologist at St Vincent's Hospital Dr Chamara Basnayake said more than half of the patients within
the trial had attempted dietary therapy previously, and 60 per cent
were classified as anxious, highlighting further need for an integrated approach to treatment.

"Functional gastrointestinal disorders are highly prevalent in the
community with some patients experiencing extreme discomfort and illness
for prolonged periods of time," Dr Basnayake said.

"Our research shows the importance of bringing together and integrating specialists into one clinic to enable immediate frontline care and improve quality of life for patients." Researchers say further studies evaluating
the longer-term outcomes of multidisciplinary treatment is needed.

"Despite the high prevalence and health system burden, very few studies
have ever evaluated the different models of care for patients with gastrointestinal disorders," Dr Basnayake said.


========================================================================== Story Source: Materials provided by University_of_Melbourne. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Chamara Basnayake, Michael A Kamm, Annalise Stanley, Amy
Wilson-O'Brien,
Kathryn Burrell, Isabella Lees-Trinca, Angela Khera, Jim Kantidakis,
Olivia Wong, Kate Fox, Nicholas J Talley, Danny Liew, Michael
R Salzberg, Alexander J Thompson. Standard gastroenterologist
versus multidisciplinary treatment for functional gastrointestinal
disorders (MANTRA): an open-label, single-centre, randomised
controlled trial. The Lancet Gastroenterology & Hepatology, 2020;
DOI: 10.1016/S2468-1253 (20)30215-6 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200715095458.htm

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