N21 Clinical Nurse Specialist in Inflammatory Bowel Disease (CNS-IBD). Care challenges and economic sustainability. A Scoping review

Abstract Background Inflammatory Bowel Diseases (IBD), as part of an immune-mediated chronic illness with a tendency for symptom exacerbation that can be difficult to predict, have a significant impact on the patient's quality of life, greatly diminishing their overall well-being. The healthcare demand of patients and the need to continue improving health-related quality of life (HRQoL) while reducing healthcare expenditure create the necessity for the role of the Clinical Nurse Specialist in Inflammatory Bowel Disease (CNS-IBD) to achieve therapeutic success. Therefore, the main objectives of our research are to assess the relationship between consultations with the Clinical Nurse Specialist in Inflammatory Bowel Disease and the patient's health-related quality of life, and, secondarily, to evaluate the economic sustainability of this consultation within healthcare systems. Methods Searches were conducted in the following databases: PubMed, UpToDate, Cochrane Library, Scopus, and CINAHL, as well as in relevant scientific journals: BMJ Open and The New England Journal of Medicine (NEJM). There were no time or language restrictions. A total of n = 6,620 articles were retrieved. After applying eligibility criteria, n = 257 articles were deemed potentially relevant for abstract review. N = 117 articles were reviewed in full. Finally, n = 5 studies published between 2012 and 2022 were included. Results The results show an improvement in health-related quality of life, as measured by the IBDQ-32 and the PRO measures questionnaire, thanks to greater patient empowerment and better disease management. The reduction in hospital admissions and the prompt response to flare-ups indicate a decrease in healthcare costs and the burden on healthcare facilities. Conclusion This scoping review summarises the current scientific evidence regarding the effectiveness of the Clinical Nurse Specialist in Inflammatory Bowel Disease and its impact on improving the health-related quality of life of patients, as well as the efficiency and sustainability it can offer to healthcare institutions. The evidence in this scoping review suggests that CNS-IBDs play a key role in patient care and the improvement of HRQoL. However, medical follow-up and treatment remain essential for better control of clinical symptoms. Studies addressing the economic efficiency of this intervention within our research yielded significantly positive results. Nevertheless, the scientific evidence is limited, with a clear shortage of studies specifically focusing on nursing practice to improve the life conditions of patients.