PWE-059 Travelling with inflammatory bowel disease (IBD): barriers, fears, concerns and suggestions for support

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Abstract

Introduction

IBD can act as a barrier to overseas travel due to concerns about travel related morbidity. This study aims to identify barriers, fears and concerns of IBD patients with regards to travel and possible areas of support from the IBD team.

Method

136 IBD patients were selected using convenience sampling. They completed a questionnaire focused on travel with IBD and specific travel issues (decision to travel, insurance, pre-trip advice, vaccination, previous flares while abroad, high altitude travel, assistance while overseas).

Result

136 patients completed the questionnaire, 70 were male (51.4%), 73 had Crohn’s Disease, 53 had Ulcerative Colitis (UC), 3 had Indeterminate Colitis and 7 were unsure. 56.6% of patients were taking 5-ASAs, 52.9% were on immunosuppressant therapy and 20.6% receiving biologics. 89% had travelled abroad since their IBD was diagnosed, 30% reported IBD limited their travel and 40% said it affected their choice of destination. 61% worried about healthcare problems abroad. 7% were refused health insurance and 47% had travelled abroad uninsured. 9% travelled uninsured due to their current diagnosis of IBD. Only 64% felt that they had received adequate pre-travel medical advice. 78% wanted advice from their doctor for future travel. 60% were unaware that taking immunosuppressant medication could affect their vaccinations and 63% on immunosuppressant therapy of biologics claimed they were uninformed of the need to avoid live vaccines. 12% received live vaccines prior to travel. Suggestions for travel help: 91% requested a written/electronic prescription for their journey, 75% wanted specific management advice, 68% a written management plan. 68% felt a doctor’s note could help them secure health insurance. 38% of patients who travelled abroad were suffering/recovering from a flare and 18% travelled despite being within a week of a flare. 92% were unaware that high altitudes could precipitate a flare. 27% travelled to high altitude destinations and of these 46% experienced a flare whilst travelling or within 4 weeks of travel. 72% were unaware of the ‘Can’t Wait Card’ and 96% never heard about the IBD passport website.

Conclusion

IBD has a big impact on travel for a broad range of reasons. Refusal of health insurance, coupled with higher premiums could explain why many IBD patients travel abroad uninsured. Providing a doctor’s note confirming fitness to travel was a popular solution chosen by patients. A majority were interested in doctors providing written management plans and prescriptions prior to their travel. Despite over half of the study being on immunosuppressant therapy, most were unaware of avoiding live vaccines whilst taking them. Better advice from health care professionals makes this entirely avoidable. Most IBD patients were unaware that high altitudes may precipitate flares. A large majority were unaware of the ‘Can’t Wait Card’ and IBD passport services. Pre-emptive discussions around travel plans should be part of the IBD clinic review.

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