Psychosocial stress as an indicator for disease severity, impairments in mental health, medication and health care utilization in patients with Crohn's disease (CD) or ulcerative colitis (UC). Evaluation of a short scale of perceived stress in inflammatory bowel diseases (IBD)

Abstract Background Inflammatory bowel diseases (IBD) are rising in prevalence and are associated with high health care costs. We estimated trends in U.S. health care spending in patients with IBD between 1996 and 2016. Methods We used data on national health care spending developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project. We estimated corresponding U.S. age-specific prevalence of IBD from the Global Burden of Diseases Study. From these 2 sources, we estimated prevalence-adjusted, temporal trends in U.S. health care spending in patients with IBD, stratified by age groups (<20 years, 20-44 years, 45-64 years, ≥65 years) and by type of care (ambulatory, inpatient, emergency department [ED], pharmaceutical prescriptions, and nursing care), using joinpoint regression, expressed as an annual percentage change (APC) with 95% confidence intervals. Results Overall, annual U.S. health care spending on IBD increased from $6.4 billion (95% confidence interval, 5.7-7.4) in 1996 to $25.4 billion (95% confidence interval, 22.4-28.7) in 2016, corresponding to a per patient increase in annual spending from $5714 to $14,033. Substantial increases in per patient spending on IBD were observed in patients aged ≥45 years. Between 2011 and 2016, inpatient and ED care accounted for 55.8% of total spending and pharmaceuticals accounted for 19.9%, with variation across age groups (inpatient/ED vs pharmaceuticals: ages ≥65 years, 57.6% vs 11.2%; ages 45-64 years, 49.5% vs 26.9%; ages 20-44 years, 59.2% vs 23.6%). Conclusions Even after adjusting for rising prevalence, U.S. health care spending on IBD continues to progressively increase, primarily in middle-aged and older adults, with unplanned health care utilization accounting for the majority of costs.

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Faculty Opinions recommendation of High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725298509.793514440 ◽

2016 ◽

Author(s):

Ashish Patel

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Diseases ◽

High Density ◽

Density Mapping ◽

Bowel Diseases ◽

Inflammatory Bowel

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Curative Ayurvedic approach to Ulcerative colitis - A Case Report

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v1i2.3675 ◽

2016 ◽

Vol 1 (2) ◽

Cited By ~ 1

Author(s):

Dr. Sumedh Wasnik ◽

Anita Ghodke ◽

Vaibhav Sulakhe

Keyword(s):

Ulcerative Colitis ◽

Weight Loss ◽

Immune Suppression ◽

Inflammatory Bowel Diseases ◽

Life Style ◽

Intravenous Fluids ◽

Genetic Origin ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Difficult Issue

Westernization and today’s changing life style is resulting in various health problems like Inflammatory Bowel diseases, which is a common entity encountered in surgical practise. Ulcerative colitis is the most common among them. Though it is believed to have auto immune and genetic origin, today’s life style, environment, diet and stress plays an important role in aetiology. The disease is prevalent in middle aged western and northern people characterised by abdominal pain with bloody diarrhoea, weight loss, anaemia and general debility. This condition has remissions and exacerbations. One should always keep in mind that inflammatory bowel diseases can have anorectal manifestations. Diagnosis is made on the basis of symptoms, stool exam. and endoscopy. Management is symptomatic i.e. antibiotics, anti-inflammatory, anti-spasmodic, multivitamins, immune suppression and if required admission, intravenous fluids. if no response colectomy. As such there is no satisfactory treatment till date, so it remains the difficult issue. Here we need to have an alternative, safe, convenient treatment. Ayurveda has an answer for such cases.

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Sa512 URBAN-RURAL DIFFERENCES IN HEALTH CARE UTILIZATION FOR INFLAMMATORY BOWEL DISEASE IN THE UNITED STATES, 2017

Gastroenterology ◽

10.1016/s0016-5085(21)01968-5 ◽

2021 ◽

Vol 160 (6) ◽

pp. S-529-S-530

Author(s):

Fang Xu ◽

Susan Carlson ◽

Kurt Greenlund

Keyword(s):

United States ◽

Health Care ◽

Inflammatory Bowel Disease ◽

Health Care Utilization ◽

Bowel Disease ◽

The United States ◽

Care Utilization ◽

Urban Rural ◽

Inflammatory Bowel

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Recurrent myocarditis in a patient with active ulcerative colitis: a case report and review of the literature

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000587 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000587

Author(s):

Giacomo Caio ◽

Lisa Lungaro ◽

Fabio Caputo ◽

Maria Muccinelli ◽

Maria Caterina Marcello ◽

...

Keyword(s):

Ulcerative Colitis ◽

Case Report ◽

Inflammatory Bowel Diseases ◽

Drug Toxicity ◽

Active Ulcerative Colitis ◽

Extraintestinal Manifestations ◽

Review Of The Literature ◽

Extraintestinal Manifestation ◽

Bowel Diseases ◽

Inflammatory Bowel

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.

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A183 TELEHEALTH USE IN RURAL SASKATCHEWAN AND INFLAMMATORY BOWEL DISEASE OUTCOMES

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.181 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 197-199

Author(s):

M Patterson ◽

M Gozdzik ◽

J Peña-Sánchez ◽

S Fowler

Keyword(s):

Health Care ◽

Inflammatory Bowel Disease ◽

Health Care Utilization ◽

Bowel Disease ◽

Postal Code ◽

Care Utilization ◽

Specialist Care ◽

Disease Characteristics ◽

Significant Difference ◽

Inflammatory Bowel

Abstract Background Appropriate management of inflammatory bowel disease (IBD) often requires multiple specialist appointments per year. Living in rural locations may pose a barrier to regular specialist care. Saskatchewan (SK) has a large rural population. Prior to COVID-19, telehealth (TH) in SK was not routinely used for either patient assessment or follow up. Furthermore, TH was exclusively between hospitals and specific TH sites without direct contact using patient’s personal phones. Aims The objective of this study was to assess the differences in demographics, disease characteristics, outcomes, and health care utilization between patients from rural SK with IBD who used TH and those who did not. Methods A retrospective chart review was completed on all rural patients (postal code S0*) with IBD in SK who were followed at the Multidisciplinary IBD Clinic in Saskatoon between January 2018 and February 2020. Patients were classified as using TH if they had ever used it. Information on demographics, disease characteristics, and access to IBD-related health care in the year prior to their last IBD clinic visit or endoscopy was collected. Data was not collected for clinic visits after March 1, 2020 as all outpatient care became remote secondary to the COVID-19 pandemic. Mean, standard deviations, median and interquartile ranges (IQR) were reported. Mann-Witney U and Chi-Square tests were used to determine differences between the groups. Results In total, 288 rural SK IBD patients were included, 30 (10.4%) used TH and 258 (89.6%) did not. Patient demographics were not significantly different between the two groups; although, there was a statistically significant difference in the proportion of ulcerative colitis patients (17% TH vs. 38% non-TH, p=0.02). The percentage of patients with clinical remission was 87% for TH patients and 74% for non-TH patients (p=0.13). There were no significant differences in health care utilization patterns and biochemical markers of disease, including c-reactive protein (CRP) and fecal calprotectin (FCP) (p>0.05). Conclusions Prior to the pandemic, a small percentage of patients with IBD in rural SK ever used TH. A small proportion of UC patients used TH. No significant differences in disease characteristics, outcomes, or health care utilization were identified. Further study is warranted to identify barriers to use of this technology to tailor care to this patient group and improve access to care, especially now as the COVID-19 pandemic has drastically changed the use of virtual care. Funding Agencies None

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The employment and mental health impact of integrated improving access to psychological therapies services: Evidence on secondary health care utilization from a pragmatic trial in three English counties

Journal of Health Services Research & Policy ◽

10.1177/1355819621997493 ◽

2021 ◽

pp. 135581962199749

Author(s):

Veronica Toffolutti ◽

David Stuckler ◽

Martin McKee ◽

Ineke Wolsey ◽

Judith Chapman ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Utilization ◽

Physical Health ◽

Health Problems ◽

Care Utilization ◽

Psychological Therapies ◽

Physical Health Problems ◽

Secondary Health Care

Objective Patients with a combination of long-term physical health problems can face barriers in obtaining appropriate treatment for co-existing mental health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical health problems. We ask whether such services can reduce secondary health care utilization costs and improve the employment prospects of those so affected. Methods We used a stepped-wedge design of two cohorts of a total of 1,096 patients with depression and/or anxiety and comorbid long-term physical health conditions from three counties within the Thames Valley from March to August 2017. Panels were balanced. Difference-in-difference models were employed in an intention-to-treat analysis. Results The new Integrated-IAPT was associated with a decrease of 6.15 (95% CI: −6.84 to −5.45) [4.83 (95% CI: −5.47 to −4.19]) points in the Patient Health Questionnaire-9 [generalized anxiety disorder-7] and £360 (95% CI: –£559 to –£162) in terms of secondary health care utilization costs per person in the first three months of treatment. The Integrated-IAPT was also associated with an 8.44% (95% CI: 1.93% to 14.9%) increased probability that those who were unemployed transitioned to employment. Conclusions Mental health treatment in care model with Integrated-IAPT seems to have significantly reduced secondary health care utilization costs among persons with long-term physical health conditions and increased their probability of employment.

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