P030 WHAT ABOUT DEPRESSION? INCREASED DISCUSSION BY GASTROENTEROLOGISTS MAY BE NEEDED.

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S59-S59
Author(s):  
Katherine Negreira ◽  
Jessica Gibilisco ◽  
Vinay Rao ◽  
Jenny Dave ◽  
Marie Borum
Keyword(s):  
Psychological Health ◽  
Disease Type ◽  
Care Utilization ◽  
Indeterminate Colitis ◽  
Exact Test ◽  
Included Patient ◽  
Significant Difference ◽  
Prevalence Of Depression ◽  
Inflammatory Bowel

Abstract Introduction Studies have reported an increased prevalence of depression in patients with inflammatory bowel disease (IBD). Depression rates have been reported as high as 21.2% in IBD patients compared to 13.4% in healthy controls (1). Addressing depression and improvement in psychological health has been associated with decrease in IBD-related morbidity, reduction in health-care utilization and improvement in quality of life (2). This study evaluated the rate at which gastroenterology providers discussed or documented depression and /or anxiety in IBD patients. Methods A 5-year chart review of all IBD patients seen in a university GI clinic was conducted. A confidential database using Microsoft Excel included patient age, gender, race, disease type, depression or anxiety (in GI notes or remainder of electronic medical record) was created. Statistical analysis using Fisher’s Exact Test was performed with significance set at p<0.05. The study was approved by the institutional IRB. Results 381 records of IBD patients were reviewed. There were 209 females and 172 males (mean age 44 years; range 20–82). 96 had Crohn’s disease, 279 had Ulcerative Colitis, and 6 had indeterminate colitis. Self-reported race/ethnicity included 195 White, 97 African American (AA), 11 Asian, 1 Hawaiian, 34 other and 43 did not document an ethnicity. 66 (17.32%) patients had depression and/or anxiety, 298 (78.22%) did not have depression and/or anxiety and 17 (4.46%) patients did not have documentation of mental health discussion during appointments. In patients with depression and/or anxiety, 46.97% had it documented by a gastroenterology provider. There was no statistically significant difference of depression and / or anxiety based upon gender (p=1.000), ethnicity (White vs AA p=1.000; White vs Asian p=0.2129; Asian vs AA p=0.208) or disease type (p=0.091). Conclusion Depression is reported to occur more frequently in patients with IBD compared to the general population. However, this study revealed that university gastroenterology providers did not consistently document the presence of or a discussion about depression and/or anxiety. While this study is limited based upon size and single institution design, it suggests that increased attention to psychological health is needed in IBD patients to optimize health and clinical outcomes. References

P014 IBD AND VTE RISK: LET’S TALK ABOUT IT

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Jenny Dave ◽  
Karan Chawla ◽  
Francis Carro-Cruz ◽  
Vinay Rao ◽  
Jessica Gibilisco ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Institutional Design ◽  
Fold Increase ◽  
Disease Type ◽  
Indeterminate Colitis ◽  
Exact Test ◽  
Significant Difference ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) have a 1.5–3 fold increase in the risk of venous thromboembolism (VTE). Additionally, VTE in patients with IBD is associated with a 2.1 fold increase in mortality compared to the general population. The risk of VTE is increased with active inflammation. It is speculated that individuals with IBD are inconsistently advised about VTE risk. This study evaluated the frequency of counseling about VTE in IBD patients. Methods A retrospective medical record review of all IBD patients seen at a university gastroenterology practice during a 5 year period was performed. Patients’ age, gender, disease type and documented counselling about VTE risk were obtained. A database was created maintaining patient confidentiality. Analysis was conducted using Fisher’s Exact Test with significance set at p< 0.05. The study was approved by the university IRB. Results Records of 381 patients were reviewed. There were 209 females and 172 males with a mean age of 44 years (range 20–82). 279 had ulcerative colitis, 96 had Crohn’s disease and 6 had indeterminate colitis. Self-reported ethnicity included 195 White, 97 Black/African-American (AA), 11 Asian, 1 Hawaiian, 34 other and 43 did not report their ethnicity. 13 (3.4%) patients (7 females, 6 males) were counselled about VTE risk. The 7 women who were counselled were <50, with no significant difference in counselling of women <50 compared to women >50 (p=0.11). The 6 men who were counseled were <50, with no significant difference in counseling of men <50 compared to men >50 (p=0.09). There was no difference in the rate of counselling based upon gender (p=1.000), ethnicity (Whites vs. non-Whites, p=0.77; Whites vs. AA, p=1.00) or disease type (p=0.31). Discussion Venous thromboembolism is a known risk of inflammatory bowel disease. While VTEs infrequently occur in IBD patients, it is important that there is awareness about the potential risk. This study revealed that VTE risk is rarely discussed with IBD patients. While this study is limited by single institutional design, size and reliance on documentation, it suggests that increased efforts can be made to educate IBD patients about VTEs. Recognition of VTE risks can improve IBD management and optimize clinical outcomes.

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

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 Prevalence of Joint Hypermobility and Patterns of Articular Manifestations in Patients with Inflammatory Bowel Disease

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
P. Vounotrypidis ◽  
E. Efremidou ◽  
P. Zezos ◽  
M. Pitiakoudis ◽  
E. Maltezos ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Study Groups ◽  
Joint Hypermobility ◽  
Fisher Exact Test ◽  
Hypermobility Syndrome ◽  
Exact Test ◽  
Significant Difference ◽  
Healthy Control ◽  
Inflammatory Bowel

Objective. The objective is the investigation of Joint Hypermobility (JH) and the Hypermobility Syndrome (HMS) in patients with inflammatory bowel disease (IBD).Methods. We examined 83 patients with IBD and 67 healthy individuals for the presence of JH. Patients were excluded if they were under 18 or over 50 years of age and if they had other conditions which affect joint mobility. Thex2and the Fisher exact test were used appropriately between study groups. Odds ratios (ORs) for the risk of JH and HMS in IBD groups were calculated.Results. A total of 150 individuals (83 IBD patients and 67 healthy controls) participated in the study. 69 IBD patients, 41 with Crohn's Disease (CD) and 28 with ulcerative colitis (UC), were finally eligible. JH was detected in 29 CD patients (70.7%), in 10 UC patients (35.7%), and in 17 healthy control subjects (25.4%). Significant difference was detected on JH in CD patients as compared to UC patients (P=.0063) and controls (P<.0001). The estimated OR for JH was 7.108 (95% CI: 2.98–16.95) in CD and 1.634 (95% CI: 0.63–4.22) in UC patients. HMS was detected in 5 (12.2%) CD and in 1 (3.57%) UC patients. The OR for HMS in CD was 3.75 (95% CI: 0.41–34.007), while 7 (17.1%) CD patients had overlapping symptoms for both HMS and early spondylarthropathy.Conclusions. JH and the HMS are common in CD patients, thus articular manifestations should be carefully interpreted. This implies an involvement of collagen varieties in the pathogenesis of IBD.

P025 THE PRIOR AUTHORIZATION PREDICAMENT: AN EVALUATION OF TIME TO INITIATION OF BIOLOGIC TREATMENT IN IBD PATIENTS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S56-S57
Author(s):  
Vinay Rao ◽  
Scott Baumgartner ◽  
Danielle Kirelik ◽  
Katherine Negreira ◽  
Jessica Gibilisco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Center ◽  
Wait Time ◽  
Indeterminate Colitis ◽  
Prior Authorization ◽  
Biologic Treatment ◽  
Patient Demographics ◽  
Time To Initiation ◽  
Significant Difference

Abstract Background Biologics are a mainstay in the treatment of moderate-severe IBD. Unlike other IBD medications, biologics typically require prior authorization from insurance providers. There is a paucity of information characterizing the length of the authorization process. Delays in the initiation of biologic therapy have the potential to impact clinical outcomes and quality of life. This study identified the time of biologic prescription and subsequent time for authorization and time of administration at a university medical center. Methods A chart review evaluating IBD patients seen in the GI clinic of a university medical center over a 5-year period was performed. Patient age, gender, race, IBD diagnosis, and biologic use were recorded in a confidential database generated using Microsoft Excel. Biologic agents evaluated included infliximab, adalimumab, vedolizumab and ustekinumab. The agreed upon date (AUD) of starting a biologic, length of time to approval (TTA), and length of time to first infusion (TFI) were recorded. TTA was set as the number of days between agreeing to start a biologic and prior authorization approval. TFI was set as the number of days between agreeing to start a biologic and their first infusion or injection. Patients were excluded if biologic was initiated at another institution or documentation of AUD or TFI was not apparent. Statistical analysis was performed using a t-test with significance set at p&lt;0.05. The study was approved by the institutional IRB. Results 458 total IBD patients were analyzed. 66 are currently being treated with a biologic (32 infliximab, 14 adalimumab, 13 vedolizumab, 7 ustekinumab). 37 patients had ulcerative colitis, 27 Crohn’s disease, and 2 indeterminate colitis. There were 38 men and 28 women (mean age 43.2 years; range 23–76). 32 patients were white, 26 African American, 1 Asian, 5 other/unknown, and 2 declined. Average TTA was 30.5 days (range 1–145) and average TFI was 45.3 days (range 2–166). There was no significant difference in TFI between a specific biologic compared to all others: infliximab (p=0.615), adalimumab (p=0.183), vedolizumab (p=0.804), ustekinumab (p=0.812). There were no significant differences in TFI with regard to gender (p=0.562), race (p=0.575), or IBD diagnosis (p=0.209). Discussion In IBD patients with an indication for biologic treatment, reducing the time to initiation of biologics can result in improved patient outcomes and quality of life. Average wait time for first infusion at our institution was 43.5 days with no difference based on the type of biologic or patient demographics. While a national benchmark does not exist for initiating patients on biologics, there is a need for continued evaluation of the authorization and treatment processes. As new biologic therapies for IBD become available, streamlining the approval process will be of increasing importance.

scholarly journals Work Productivity Loss in Inflammatory Bowel Disease Patients in Turkey

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Firdevs Topal ◽  
Hakan Camyar ◽  
Elif Saritas Yuksel ◽  
Suleyman Gunay ◽  
Fatih Topal ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Online Survey ◽  
Productivity Loss ◽  
Young Patients ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
The Impact

Background. Beyond the medical treatment in inflammatory bowel disease (IBD), there are other issues which influence the quality of life adversely. The aim of this study was to determine the impact of the IBD patients’ illness on working and education life. Method. The participants were invited to participate in the online survey from the Turkish Crohn’s and Ulcerative Colitis Patient Association network. The data was analysed and then discussed to improve the health-related quality of working and education life. Results. One hundred and fifteen patients had ulcerative colitis (UC) (57.2%), and 86 had Crohn’s disease (CD) (42.8%). There was a statistically significant difference in UC between retirement age group 1 (<40 age) and groups 2 (40-49 ages) and 4 (60-65 ages) (p<0.05). There was the same significant difference in CD. Even though the data did not have significant statistical difference, there was clustering around negative perceptions the patients have about their working and education lives. Conclusion. Our survey revealed a very strong causative relationship between work and IBD involving problems before, during, and at the end of employment. Young patients lower their career expectations, and that announces a clear need to support them and improve career guidance.

scholarly journals The Impact of COVID-19 Infection on the Quality of Life of Health Care Workers

2021 ◽  
Author(s):  
Sadeel Shanshal ◽  
Harith Kh. Al-Qazaz
Keyword(s):  
Quality Of Life ◽  
Sleep Quality ◽  
Psychological Health ◽  
World Health ◽  
World Health Organization Quality ◽  
Significant Difference ◽  
Males And Females ◽  
The Mean ◽  
The Impact

Abstract Background: COVID-19 pandemic has negatively affected the entire world and one of its impacts was the increased level of stress and anxiety, especially among healthcare workers. Therefore, this study aims at evaluating the quality of life (QoL) and sleep quality of healthcare professionals in Iraq.Methods: This study assessed the QoL and sleep quality by using World Health Organization Quality of Life Instruments (WHOQOL-BREF) and the Insomnia Severity Index (ISI) respectively. The questionnaires were administered through an online cross-sectional survey targeted at workers in medical fields in Iraq from 1st to 20th of August 2021. Results: Three hundred medical health workers participated, and females constituted 75.3%. The two questionnaires had very good internal consistency. The highest scoring domain was the social relationships, followed by physical health. Significant difference was found in the mean scores of psychological health domain between males and females, with higher scores observed in males. The mean of the total ISI score was 11.58 ± 6.88 with a range between 0 and 27. Severe insomnia was observed in only 9.7% of the participants. A significant negative correlation (r = -0.118) was found between age and ISI scores of the participants. Significant differences were found between males and females with higher ISI mean score observed among males. Conclusion: The quality of life and sleep pattern can be impacted by COVID-19 infection with the psychological aspect of QoL being the most affected and some degrees of insomnia being observed in many participants.

scholarly journals Age as the Risk Factor that Affected the Increased Degree of Uterine Prolapse

2018 ◽  
Vol 1 (1) ◽  
pp. 20
Author(s):  
Shervil Kagayaita Sayko ◽  
Eighty Mardiyan Kurniawati ◽  
Pudji Lestari
Keyword(s):  
Elderly Women ◽  
Uterine Prolapse ◽  
Fisher Exact Test ◽  
Test Statistic ◽  
Cross Sectional ◽  
Significance Level ◽  
Exact Test ◽  
Significant Difference ◽  
The Relationship

Introduction: Uterine prolapse is a gynecological problem that women often experience with a prevalence of 50% and is predicted that the next 30 years will increase by 45% as life expectancy increases. Increased degrees of uterine prolapse have an impact on the deterioration of women's quality of life. The uterine prolapse is influenced by several mutually supportive factors. The purpose of this study was to analyze the relationship between these factors to the degree of uterine prolapse.Methods: This research is an observational analytic research with cross sectional approach. The number of samples were 65 patients with uterine prolapse at Policlinic Gynecology RSUD Dr. Soetomo Surabaya from 2015-2017. Sampling was done by consecutive sampling. To find out the significant level, the collected data will be tested with Fisher Exact Test statistic at significance level α = 0,05.Results: The result showed that there was significant difference between degree of uterine prolapse with age factor (p = 0,016) and obesity (p = 0,041). As for the parity factor (p = 0.508) there was no significant difference between the parity factor and the degree of uterine prolapse.Discussion: Age is a major factor affecting the degree of uterine prolapse, weakening of pelvic floor tissue and muscle in elderly women is the main cause. While on the obesity factor, there is no data to support that obesity is related to the degree of uterine prolapse because the trend indicates that the majority of patients are not obese. In contrast the parity factor, although according to the statistical test there is no difference to the degree of uterine prolapse, the trend shows that parity leads to increased incidence of uterine prolapse itself.Conclusion: Age is a factor that affects the degree of uterine prolapse.

scholarly journals The role of folded fibular flap in patients’ reconstruction of mandibular defects: a retrospective clinical study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ning Gao ◽  
Kun Fu ◽  
Jinghua Cai ◽  
Hao Chen ◽  
Wei He
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Short Form ◽  
Life Questionnaire ◽  
Preoperative Level ◽  
Sf 36 ◽  
Retrospective Clinical Study ◽  
Significant Difference ◽  
Fibular Flap

AbstractThis study has analyzed 41 patients with mandibular ameloblastoma who underwent a partial mandibulectomy and reconstruction by folding the free fibular flap. In the preoperative and postoperative (6 months and 24 months after surgery), the Quality of Life (QOL) of these patients was assessed by using the University of Washington Quality of Life Questionnaire (UW-QOL) and the medical outcome study short form-36 (SF-36) questionnaires. SPSS 20.0 statistical software was used to conduct statistical analysis on the base data of the two groups of patients. Independent sample t test was conducted for sf-36 and UW-QOL scores at two time points in each group. The SF-36 survey showed that body pain (54.54 ± 8.10), general health (55.27 ± 7.54), and health changes (58.29 ± 9.60) decreased significantly at 6 months after surgery, but the mean score at 24 months after surgery all exceeded the preoperational level. At 24 months after the surgery, the vitality (80.41 ± 3.74), social function (81.61 ± 4.07), emotional role (82.39 ± 4.07), psychological health (81.66 ± 4.37) and total score (704.00 ± 31.53) all returned to the preoperative level, which was statistically significant compared with 6 months after surgery. However, there was no significant difference compared with the preoperative level. The UW-QOL survey showed that chewing (56.68 ± 7.23), speech (54.54 ± 7.7) and taste (62.29 ± 10.15) have significantly changed at 6 months after the surgery, and the difference was statistically significant at 24 months after surgery. Saliva generation decreased slightly (80.76 ± 3.35) at 6 months after surgery, but quickly returned to the preoperative level (81.59 ± 4.06). The total score of the patients almost recovered to the preoperative level at 24 months after surgery. The folded the fibular flap can not only repair the defects of soft tissue and bone tissue, but also restore the height of the alveolar ridge to, avoid the imbalance of crown and root ratio after implantation and reduce the occurrence of peri-implant inflammation, so that a true functional reconstruction can be realized.

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