A novel approach to managing patients with idiopathic gastroparesis: a quality improvement project
Introduction: Idiopathic gastroparesis, as defined by neurogastroenterology and motility societies, is delayed gastric emptying without mechanical obstruction.1 Patients with idiopathic gastroparesis were historically overinvestigated and not holistically managed. Holistic management would involve p...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Future Healthcare Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2514664525001432 |
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| Summary: | Introduction: Idiopathic gastroparesis, as defined by neurogastroenterology and motility societies, is delayed gastric emptying without mechanical obstruction.1 Patients with idiopathic gastroparesis were historically overinvestigated and not holistically managed. Holistic management would involve providing patients with dietary advice, mental health support and support for other chronic symptoms, such as pain. In light of this, North Bristol NHS Trust designed an idiopathic gastroparesis pathway, which included referral to a multidisciplinary team (MDT) of healthcare professionals including dieticians, psychologists, other mental health services and pain services. Methodologies: In the second cycle of this quality improvement project (QIP), we reviewed 13 patients referred through the idiopathic gastroparesis pathway. The analysis included parameters such as the frequency of radiological investigations before and after diagnosis and referral to MDT, the time to the MDT review and the number of inpatient emergency and elective admissions to the North Bristol NHS Trust due to gastric issues. Furthermore, we examined the past medical history and psychiatric comorbidities of these patients. Results: In total, 13 patients’ records (12 female, one male) were reviewed, revealing an average age of 32 years at diagnosis. Of these patients, 46% had established psychiatric comorbidities, with significant associations with POTS and Ehler Danlos’ Syndromes. Between 31 May 2022 and 1 June 2023, radiological investigations averaged 0.23, a considerable decline from 1.80 in the previous cycle. Patients were referred to the dietary services in all cases; however, 30% lacked psychological evaluations. The emergency inpatient admissions for the gastrointestinal system dropped from 14.611 to 0.69. Conclusions: The results of the above QIP demonstrate the effectiveness of the pathway in holistic management and early access to the MDT of healthcare professionals, which is crucial in idiopathic gastroparesis treatment. The reduced frequency of radiological investigations and inpatient emergency admissions for gastrointestinal symptoms shed positive light on health service use and resource redirection. The lack of psychological assessments in patients indicates the need for reorientation of healthcare staff about the pathway to increase referrals. |
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| ISSN: | 2514-6645 |