Gaps between European Crohn's Colitis Organisation quality standards of care and the real world on structure of IBD units across Europe: results from E-QUALITY survey

Abstract

Background and aims: Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, require an interdisciplinary approach for diagnosis, monitoring, and management. The European Crohn's and Colitis Organisation (ECCO) has developed evidence-based recommendations and quality care standards for IBD management, but gaps between these standards and real-world practice persist. The E-QUALITY task force aimed to evaluate the structure, processes, and outcomes of IBD units across Europe and identify barriers to achieving ECCO quality standards.

Methods: A web-based survey was conducted from September 2022 to October 2024 among 245 institutions in 35 European countries. The survey assessed unit structure, interdisciplinary care, services, facilities, and barriers to achieving quality care standards. Subgroup analyses were performed based on institution type, patient volume, and geographical distribution.

Results: Formal IBD units were present in 68% of institutions, with interdisciplinary teams available in 94%. Institutions with >500 active patients were more likely to meet ECCO standards for interdisciplinary care, quality indicators, and patient support but faced challenges such as lack of time and referral pathways. Geographical disparities significantly influenced the availability of resources and services. Key barriers to quality care included lack of time (71%), personnel (69%), and funding (45%).

Conclusions: Significant gaps in quality care standards remain across European IBD units. Enhanced support from ECCO, by education and position papers/guidelines may help bridge these gaps.

Keywords: Crohn’s disease; inflammatory bowel disease; quality of care; ulcerative colitis.