scholarly journals N15 Transition of care programme and treatment adherence in adolescents with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S615-S615
Author(s):  
N Garzia Stafrace
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Treatment Adherence ◽  
Psychosocial Development ◽  
Bowel Disease ◽  
Care Delivery ◽  
Heart Diseases ◽  
Transition Of Care ◽  
Care Programme ◽  
Inflammatory Bowel

Abstract Background The purpose of this study was to address the grey areas influencing the transition of care (TOC) aspect in adolescents suffering from IBD. In the context of healthcare, the term ‘transition’ refers to a phase of development from one stage to another. ‘TOC’ is defined as the “purposeful planned movement of adolescents and young adults with chronic conditions from child-centred to adult-oriented health care systems” (Blum et al., 1993). The point where the adolescent becomes an adult represents a milestone not only in health care delivery but also in the wider context of knowledge of medication, education, and employment, as well as sexual and psychosocial development amongst others (Greveson et al., 2011). Although this concept of care is still in its early stages, it has found its application in various specialities of medicine, including but not limited to diabetes, juvenile rheumatology, congenital heart diseases (Afzali & Wahbeh, 2017) and gastroenterology conditions, namely inflammatory bowel disease (IBD). Methods From this systematic review of literature that discussed TOC, it became evident that this essential process is undervalued and understudied. Transition standards vary between healthcare services and goals. The selected 3 cross-sectional, 1 cohort and 1 multi-site comparison studies published between 2013 and 2018 analysed how IBD treatment compliance in adolescents is affected when going through an established TOC compared to no TOC. While TOC has successfully created clinical targets, identified deficiencies in knowledge, adherence, and transition readiness assessments, there are still few evidence-based tools to assist in the transition process and a relative absence of transition models that have been critically appraised (Bollegala & Nguyen, 2015). Results Findings determined that the establishment and attendance of IBD adolescent patients in structured TOC programmes or clinics ensure cohesive treatment adherence. Nevertheless, it was established that further studies must be carried out on the matter at hand. Conclusion Recommendations for clinical practice, management, education, and further studies were endorsed. Such suggestions concluded that transition should be delayed until the patient has been assessed for readiness, along with the importance of involving a multidisciplinary team and the development of practical guidelines and skills aimed for optimal, lifelong IBD management.

The Pediatric Inflammatory Bowel Disease Medical Home: A Proposed Model

2021 ◽  
Author(s):  
Hilary K Michel ◽  
Brendan Boyle ◽  
Jennie David ◽  
Amy Donegan ◽  
Barb Drobnic ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Psychosocial Development ◽  
Bowel Disease ◽  
Medical Home ◽  
Care Delivery ◽  
Adult Population ◽  
Care Quality ◽  
Care Needs ◽  
Patient Centered ◽  
Inflammatory Bowel

Abstract Care for patients with inflammatory bowel disease (IBD) can be complex and costly. Care delivery models to address these challenges and improve care quality are essential. The patient-centered medical home (PCMH), which was developed in the primary care setting, has recently been applied successfully to the adult IBD population. Following the tenets of the PCMH, this specialty medical home (SMH) emphasizes team-based care that is accessible, comprehensive, patient/family-centered, coordinated, compassionate, and continuous and has demonstrated improved patient outcomes. Children and young adults with IBD have equally complex care needs, with additional challenges not faced by the adult population such as growth, physical and psychosocial development, and transition of care from pediatric to adult providers. Thus, we advocate that the components of the PCMH are equally—if not more—important in caring for the pediatric patient population. In this article, we review what is known about the application of the PCMH model in adult IBD care, describe care delivery within the Center for Pediatric and Adolescent IBD at Nationwide Children’s Hospital as an example of a pediatric IBD medical home, and propose a research agenda to further the development and dissemination of comprehensive care delivery for children and adolescents with IBD.

scholarly journals A183 TELEHEALTH USE IN RURAL SASKATCHEWAN AND INFLAMMATORY BOWEL DISEASE OUTCOMES

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

scholarly journals Health care and patients' education in a European inflammatory bowel disease inception cohort: An ECCO-EpiCom study

2014 ◽  
Vol 8 (8) ◽  
pp. 811-818 ◽  
Author(s):  
J. Burisch ◽  
Z. Vegh ◽  
N. Pedersen ◽  
S. Čuković-Čavka ◽  
N. Turk ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inception Cohort ◽  
Inflammatory Bowel

scholarly journals Socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis

2021 ◽  
Vol 25 (1) ◽  
pp. 65-69
Author(s):  
I. V. Oleksiienko
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Pregnant Women ◽  
Bowel Disease ◽  
Clinical Analysis ◽  
Chronic Inflammatory Bowel Disease ◽  
Care Providers ◽  
History Of ◽  
Inflammatory Bowel

Annotation. At the turn of the 21st century, chronic inflammatory bowel disease (CIBD) has become a global disease with accelerating morbidity in industrialized countries with a prevalence exceeding 0.3%. These data underscore the need for research into the prevention of inflammatory bowel disease and innovations in health care systems to manage this complex and costly disease. The information from a personal anamnesis of 40 women patients with ulcerative colitis (clinical group (main). In the second group (control), 30 practically healthy pregnant women with a physiological course of gestation were included, which did not have in their history of inflammatory intestinal diseases. Statistical processing of research results was performed using the software package Statistica 6.0. The arithmetic mean (M) and the standard deviation error (± m) (p<0.05) were determined, as well as the odds ratio (OR), confidence interval (CI) at p=95%. It was found that for women with ulcerative colitis is characterized by the presence of a history of obstetric pathology, such as: spontaneous miscarriage of OR 3.33, 95% CI [1.06-10.53], p=0.04 and blood secretions of OR 3.0, 95% CI [1.00-8.98], p=0.0496; among extragenital pathology in the anamnesis: children's infectious diseases of OR 4.85, 95% CI [1.25-18.85], p=0.02, chronic bronchitis of OR 7.54, 95% CI [1,56-36, 41], p=0.01, varicose veins OR 4.33, 95% CI [1.11-16.95], p=0.035, chronic gastritis OR 6.0, 95% CI [1,23-29, 31], p=0.03, anemia of OR 15.0, 95% CI [4.53-49.68], p<0.0001, allergy history of OR 6.65, 95% CI [1.73-25.60], p=0.006; among gynecological complications – premenstrual syndrome OR 6.0, 95% CI [1.55-23.15], p=0.009, algomenorrhea OR 8.14, 95% CI [2.12-31.24], p=0.002 , salpingo-oophoritis, OR 7.54, 95% CI [1.56-36.41], p=0.01. Because CIBD during pregnancy is associated with an increased risk of adverse effects on the mother and fetus, information on socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis will be useful to health care providers in making decisions about CIBD during pregnancy.

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gil Y. Melmed ◽  
Brant Oliver ◽  
Jason K. Hou ◽  
Donald Lum ◽  
Siddharth Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Quality Of Care ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Care Program ◽  
Care Utilization ◽  
Inflammatory Bowel

scholarly journals N26 Experiences of patients with inflammatory bowel disease (IBD) regarding faecal incontinence and the guidance received

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
T T I Toivonen ◽  
K Helin ◽  
R Nikkola
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Faecal Incontinence ◽  
Bowel Disease ◽  
Bowel Function ◽  
Health Care Personnel ◽  
Wexner Score ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) suffer more often than the rest of the population from faecal incontinence, which decreases their quality of life. The purpose of this study was to describe the experiences of Finnish IBD patients regarding faecal incontinence and the guidance they need and have received for faecal incontinence. Methods The data were collected by executing focused interviews of eleven IBD patients, who at the time of the interview were in remission. The interviewees participated in the study via the Finnish patient association Crohn ja Colitis ry. The data were analysed using an inductive content analysis. Results Seven participants were men and four were women. They had had IBD for an average of 2 to 40 years. Five interviewees had Crohn’s disease and six had ulcerative colitis. The extent of the faecal incontinence and its impact on quality of life were assessed by Jorge–Wexner score, which examines the frequency of solid and loose stools and intestinal gas, use of diapers or protective pads, and the patients’ perception of the impact on the quality of life. Zero points stands for complete continence and 20 points for complete incontinence. The average Wexner score among participants was 9.8 (Figure 1). The participants felt that faecal incontinence was constantly disturbing their life. They especially wished for support and information regarding diet. Fear of faecal incontinence made participants skip planned activities and isolate themselves at home. Participants tried to anticipate bowel movements and find out toilet locations in advance in order to venture out of their homes. Participants had discussed faecal incontinence with an IBD nurse and a doctor, but none had met a continence nurse. Furthermore, none of the participants had been told about potential faecal incontinence or ways to manage it. Some participants felt that diet had improved their bowel function, although health care personnel had said in their guidance that diet has no effect on faecal incontinence. Participants also felt that they would have needed information regarding the risk of faecal incontinence and wished that they had been heard regarding problems caused by faecal incontinence. Conclusion IBD patients need guidance from health care personnel and information regarding faecal incontinence to balance their bowel function. Health care personnel taking care of IBD patients in Finland needs more training on faecal incontinence, and in addition, more guidance and criteria on when to direct a patient to a continence nurse is needed.

scholarly journals Revisiting Inflammatory Bowel Disease: Pathology, Treatments, Challenges and Emerging Therapeutics Including Drug Leads from Natural Products

2020 ◽  
Vol 9 (5) ◽  
pp. 1273 ◽  
Author(s):  
Karma Yeshi ◽  
Roland Ruscher ◽  
Luke Hunter ◽  
Norelle L. Daly ◽  
Alex Loukas ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Natural Products ◽  
Bowel Disease ◽  
Inflammatory Diseases ◽  
Treatment Options ◽  
Mucosal Healing ◽  
Main Challenge ◽  
Long Term Treatment ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) is a chronic and life-long disease characterized by gastrointestinal tract inflammation. It is caused by the interplay of the host’s genetic predisposition and immune responses, and various environmental factors. Despite many treatment options, there is no cure for IBD. The increasing incidence and prevalence of IBD and lack of effective long-term treatment options have resulted in a substantial economic burden to the healthcare system worldwide. Biologics targeting inflammatory cytokines initiated a shift from symptomatic control towards objective treatment goals such as mucosal healing. There are seven monoclonal antibody therapies excluding their biosimilars approved by the US Food and Drug Administration for induction and maintenance of clinical remission in IBD. Adverse side effects associated with almost all currently available drugs, especially biologics, is the main challenge in IBD management. Natural products have significant potential as therapeutic agents with an increasing role in health care. Given that natural products display great structural diversity and are relatively easy to modify chemically, they represent ideal scaffolds upon which to generate novel therapeutics. This review focuses on the pathology, currently available treatment options for IBD and associated challenges, and the roles played by natural products in health care. It discusses these natural products within the current biodiscovery research agenda, including the applications of drug discovery techniques and the search for next-generation drugs to treat a plethora of inflammatory diseases, with a major focus on IBD.

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