The IBD passport: bridging another gap in quality of care?

Despite unprecedented advances in our understanding of the pathogenesis of inflammatory bowel diseases and novel treatments there is abundant evidence that the quality of care delivered to IBD patients is both disparate and suboptimal. Scientific progress may have outpaced quality improvement measures. Quality of care research in IBD is fraught with challenges with the lack of established quality care measures being a significant limitation. The scenario of a patient experiencing a disease flare or related complication during travel is not unknown to gastroenterologists. It is incumbent upon gastroenterologists managing such patients to provide advice regarding destination specific vaccination and advice (usually also through a travel clinic) and additional advice regarding medication supply, travel insurance and alert bracelets, etc. It might be argued that duty of care may extend beyond hospital or “office based” care. The expectation that a patient might remember specific facts relating to her or his disease and treatment during illness or flare is unrealistic and probably inappropriate. Having a patient held record succinctly outlining IBD related information is one way of enhancing patient safety and confidence during travel and a means of appropriate communication with clinicians within the home country or abroad. We have recently developed a credit card sized booklet we call the “IBD passport” to facilitate this. This 5×8 cm document (Fig. 1) easily fits into a wallet or purse and contains within its 12 pages (including front and back cover) information relating to name, age, next of kin and contact numbers, IBD diagnosis and duration, medical and surgical history, relevant extra-intestinal features, appropriate radiographic and endoscopic investigation, current and previous medication (including previous intolerance), drug alerts