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 (R), 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 1285
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% vs. 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 vs. 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.
