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Implementing a self-management strategy in inflammatory bowel disease (IBD): patient perceptions, clinical outcomes and the impact on service
  1. Seth Ian Squires,
  2. Allan John Boal,
  3. Selina Lamont,
  4. Graham D Naismith
  1. C/O Gastroenterology Department, Royal Alexandra and Vale of Leven Hospitals, Paisley, UK
  1. Correspondence to Seth Ian Squires, C/O Gastroenterology Department, Royal Alexandra and Vale of Leven Hospitals, Corsebar Road, Paisley PA2 9PN, UK; seth.squires{at}, seth.squires{at}


Introduction Patient self-management and its service integration is not a new concept but it may be a key component in the long-term sustainability of inflammatory bowel disease (IBD) service provision, when considering growing disease prevalence and limited resources.

Methods The IBD team at the Royal Alexandra and Vale of Leven Hospitals in the Clyde Valley region developed a self-management tool, called the ‘flare card’. Patients were asked to complete a questionnaire which reflected their opinion on its viability as a self-management intervention. In addition, its utility in terms of service use over a 10-month period in 2016 was compared with a similar cohort of patients over 10 months in 2015.

Results Patients overall felt that the ‘flare card’ was a viable self-management tool. Positive feedback identified that the intervention could help them aid control over their IBD, improve medication adherence, reduce symptoms and reflected a feeling of patient-centred IBD care. The comparison between 2015 and 2016 service use revealed a significant reduction in IBD and non-IBD service usage, Steroid prescribing and unscheduled IBD care in the flare card supported cohort.

Conclusions IBD services must continue to adapt to changes within the National Health Service bearing in mind long-term sustainability and continued care provision. The ‘flare card’ goes further in an attempt to optimise Crohn's disease and ulcerative colitis management by harmonising clinician evaluation and patient's self-initiation of therapy and investigation.


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  • Twitter Follow Seth Squires @Seth Squires@SquidgeIBD

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  • Contributors SIS, AJB, GDN, SL: statistical analysis and drafting of manuscript. SIS, AJB, GDN, SL: project conception, data collection, synthesis and redrafting of manuscript.

  • Funding Dr Falk UK provides an unrestricted educational grant to print and supply the flare card in its finished and final version. Dr Falk did not contribute in any way to the writing of this paper, nor did they write or influence in any way the content of the Flare Card.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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