P1191Global Perspectives on Sustainable Inflammatory Bowel Disease Care: Results from an International Survey

Abstract Background Sustainability has emerged as a pressing concern in healthcare, with growing recognition of medicine’s contribution to global carbon emissions. However, the views of clinicians in high-resource specialties such as inflammatory bowel disease (IBD) care remain largely unexplored. Methods We conducted an international web-based survey among gastroenterologists treating IBD to assess awareness, perceived priorities, and willingness to adopt sustainable practices. The 29-item questionnaire, disseminated through professional networks between March and September 2025, explored demographics, perceived environmental impact, current practices, and openness to change Results A total of 263 gastroenterologists (mean age 45. 2 years; 48. 3% female) from 46 countries across the globe participated, mostly from high-volume centers. Most respondents (241, 91. 6%) acknowledged healthcare’s substantial environmental impact and rated it as a top (24. 7%) or important (47. 1%) priority. Endoscopy and travel to healthcare facilities were cited as the main contributors, with ∼70–75% rating their impact 6–7 on a 7-point scale. Despite this awareness, environmental considerations remained marginal in clinical decisions: only 6% deemed them highly important in treatment selection versus 82% prioritizing efficacy and 74% safety. Adoption of low-impact practices, such as telemedicine, intestinal ultrasound, or point-of-care testing, remained modest. Major barriers to greener IBD management were perceptions that sustainability is not a priority (74. 5%), lack of awareness (52. 1%), limited policy support (51. 7%), and costs (29. 3%). Nonetheless, clinicians expressed strong support for several initiatives: digital/remote medicine (74. 5%), eco-friendly packaging (63. 1%), patient referral to geographically closer centers (42. 6%), and expanded biosimilar use (31. 9%) Fig. 1. Over half (52. 9%) identified appropriateness of endoscopy as the most impactful sustainability measure. The mean willingness-to-change score was 7. 17/10, and 89. 4% were ready to accept a 5% trade-off in personal time or effort to reduce environmental impact. Conclusion This global survey reveals strong consensus among IBD specialists that sustainability matters and that clinicians are ready to act—even at personal cost. Translating this intent into coordinated, system-level change is the next step toward greener IBD care Conflict of interest: Dr. Nardone, Olga Maria: Advisory board fees from Eli Lilly, Nestlè, Janssen Speaker fees from AbbVie, Janssen, Eli Lilly, Ferring, Alfa Sigma, Recordati, Noòs, and Pfizer Danese, Silvio: Advisory board fees from Eli Lilly, Nestlè, Janssen Speaker fees from AbbVie, Janssen, Eli Lilly, Ferring, Alfa Sigma, Recordati, Noòs, and Pfizer Gros, Beatriz: Beatriz Gros has served as a speaker for Abbvie, Johnson and Johnson, Takeda, Roche, Gilead, Pfizer and Galapagos and has served as an advisor for Roche, Gilead, Abbvie, Galapagos and Takeda Calabrese, Giulio: Travel grant by Johnson and Johnson fee by Celltrion Peyrin-Biroulet, Laurent: CONSULTING Abbvie, Abivax, Adacyte, Alimentiv, Alfasigma, Amgen, Apini, Banook, BMS, Celltrion, Enthera, Ferring, Fresenius Kabi, Galapagos, Genentech, Gilead, Iterative Health, Janssen, Lilly, LifeMine, Medac, Morphic, MSD, Nordic Pharma, Novartis, Oncodesign Precision Medicine, ONO Pharma, OSE Immunotherapeuthics, Par’ Immune, Pfizer, Prometheus, Roche, Roivant, Samsung, Sandoz, Sanofi, Sorriso, Spyre, Takeda, Teva, ThirtyfiveBio, Tillots, Vectivbio, Vedanta, Ventyx. LECTURE Abbvie, Alfasigma, Amgen, Biogen, Celltrion, Ferring, Galapagos, Genentech, Gilead, Iterative Health, Janssen, Lilly, Medac, MSD, Nordic Pharma, Pfizer, Sandoz, Takeda, Tillots Kunovsky, Lumir: No conflict of interest Sebastian, Shaji: Grant: Takeda, Tillots pharma, Biogen, Pfizer, Abbvie, Johnson & Johnson, Olympus -Odin Vision Personal Fees: Tillots, Johnson & Johnson, Olympus Odin Vision, AbbVie, Takeda, Merck, Pharmacosmos, Amgen, Eli Lilly, BMS, Odin Vision Non-financial Support: Tillots, Takeda, AbbVie, Celltrion, Johnson & Johnson, Eli Lilly, Alphasigma, Ferring Pharma Parigi, Tommaso Lorenzo: Tommaso L Parigi declares no relevant conflicts of interest