Significant Differences in IBD Care and Education across Europe: Results of the Pan-European VIPER Survey

Jan Kral, Radislav Nakov, Vera Lanska, Brigida Barberio, Nicolas Benech, Andreas Blesl, Eduard Brunet, Tiago Capela, Lauranne Derikx, Gabriele Dragoni, Aileen Eek, Catarina Frias-Gomes, Georgiana Emmanuela Gîlcǎ-Blanariu, Leah Gilroy, Philip Harvey, Anna Kagramanova, Haluk Tarik Kani, Tom Konikoff, Matthias Lessing, Gorm MadsenVaidota Maksimaityte, Maria Miasnikova, Ivana Mikolasevic, Vladimir Milivojevic, Daniele Noviello, Dmytro Oliinyk, Arpad Patai, Anthea Pisani, Adonis Protopapas, Iago Rodríguez-Lago, Philipp Schreiner, Vita Skuja, Florian Tran, Marie Truyens, Marcin Włodarczyk, Hubert Zatorski, Bram Verstockt*, Jonathan Philip Segal

*Corresponding author for this work


BACKGROUND: Inflammatory bowel disease (IBD) care and education might differ around Europe. Therefore, we conducted this European Variation In IBD PracticE suRvey (VIPER) to investigate potential differences between countries.

METHODS: This trainee-initiated survey, run through SurveyMonkey®, consisted of 47 questions inquiring basic demographics, IBD training, and clinical care. Results were compared according to gross domestic product (GDP) per capita, for which countries were divided into 2 groups (low/high income, according to the World Bank).

RESULTS: The online survey was completed by 1,285 participants from 40 European countries, with a majority of specialists (65.3%) working in academic institutions (50.4%). Significant differences in IBD-specific training (55.9% vs. 38.4%), as well as availability of IBD units (58.4% vs. 39.7%) and multidisciplinary meetings (73.2% vs. 40.1%), were observed between respondees from high and low GDP countries (p < 0.0001). In high GDP countries, IBD nurses are more common (85.9% vs. 36.0%), also mirrored by more nurse-led IBD clinics (40.6% vs. 13.7%; p < 0.0001). IBD dieticians (33.4% vs. 16.5%) and psychologists (16.8% vs. 7.5%) are mainly present in high GDP countries (p < 0.0001). In the current COVID era, telemedicine is available in 73.2% versus 54.1% of the high/low GDP countries, respectively (p < 0.0001). Treat-to-target approaches are implemented everywhere (85.0%), though access to biologicals and small molecules differs significantly.

CONCLUSION: Much variability in IBD practice exists across Europe, with marked differences between high and low GDP countries. Further work is required to help address some of these inequalities, aiming to improve and standardize IBD care and training across Europe.

Original languageEnglish
JournalDigestive Diseases
Issue number3
Pages (from-to)387-395
Number of pages9
Publication statusPublished - 1 May 2023


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