scholarly journals A245 IMPROVING KNOWLEDGE TRANSFER OF PREVENTATIVE CARE IN INFLAMMATORY BOWEL DISEASE USING ELECTRONIC LEARNING

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 122-123
Author(s):  
P Tandon ◽  
A N Sasson ◽  
Z Gallinger
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Cancer Screening ◽  
Bone Health ◽  
Bowel Disease ◽  
Preventative Care ◽  
Health Maintenance ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
Educational Videos

Abstract Background Inflammatory bowel disease (IBD) is a complex chronic disease and it is imperative that gastroenterologists are familiar with the unique needs of the IBD patient. An important part of management involves education surrounding the general health maintenance needs of this patient population, especially those on immunomodulator and biologic therapy or those being considered for such treatment. A recent study showed that Canadian GI trainees are uncomfortable managing preventative care in IBD including vaccinations and bone protection. Using educational videos for trainees to improve core knowledge of these concepts remains unclear. Aims Assess educational efficacy of a core training module on trainee confidence and knowledge on preventative care in IBD. Methods This study assessed a preventative care in IBD video used as an educational tool in the University of Toronto GI trainee program as part of the annual GI in-training objective structured clinical examination (OSCE). Prior to the OSCE, a randomly selected cohort of trainees were provided the preventative care video. The remaining trainees prepared for the OSCE as standard. At the OSCE, one station asked all trainees to address preventative care in IBD with a standardized patient. Following the OSCE, a standardized evaluation of trainee confidence and degree of knowledge on vaccination, cancer screening, bone health, and mental health in IBD patients was performed. These evaluations and OSCE score were then compared between both cohorts. Data was analyzed using a t-test and p<0.05 was considered significant. Results A total of 10 subjects took part in the study. 5 subjects were exposed to the video prior to the OSCE and 5 were not exposed. Overall total score for trainees who had seen the video prior to the OSCE had a mean score of 85.3% (38.4/45) compared to those who had not seen the video prior had a mean score of 65.3% (29.4/45) with a p = 0.03. Global score in those exposed to the video was 70% (3.5/5) compared to 48% (2.4/5) in the unexposed group with a p= 0.006. Upon assessment of individuals topics, there was a trend in improved knowledge of vaccination and mental health screening in those exposed vs. unexposed to the educational video (52.6% vs. 32.6%, and 80% vs. 20%, respectively). No significant difference was identified between groups with respect to cancer screening and bone health. Conclusions Our study shows evidence that use of educational videos was efficacious with respect to GI trainee confidence and knowledge surrounding key concepts in preventative care of IBD patients. This exposure allows for improved patient education and management and lead to better-quality patient care. Overall, this study identifies a knowledge gap in trainee education and highlights the need for development of training tools to improve overall management of this complex and dynamic disease. Funding Agencies CAGVideo was a CAG accredited educational material, and supported by an educational grant from the Canadian Association of Gastroenterology and Abbvie Canada

scholarly journals Health Maintenance Consensus for Adults With Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Gaurav Syal ◽  
Mariastella Serrano ◽  
Animesh Jain ◽  
Benjamin L Cohen ◽  
Florian Rieder ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Clinical Care ◽  
Screening Tools ◽  
Preventative Care ◽  
Health Maintenance ◽  
Modified Delphi ◽  
Increased Risk ◽  
Clinical Practice Setting ◽  
Inflammatory Bowel

Abstract Background With the management of inflammatory bowel disease (IBD) becoming increasingly complex, incorporating preventive care health maintenance measures can be challenging. The aim of developing these updated recommendations is to provide more specific details to facilitate their use into a busy clinical practice setting. Method Fifteen statements were formulated with recommendations regarding the target, timing, and frequency of the health maintenance interventions in patients with IBD. We used a modified Delphi method and a literature review to establish a consensus among the panel of experts. The appropriateness of each health maintenance statement was rated on a scale of 1 to 5 (1–2 as inappropriate, and 4–5 as appropriate) by each panelist. Interventions were considered appropriate, and statements were accepted if ≥80% of the panelists agreed with a score ≥4. Results The panel approved 15 health maintenance recommendations for adults with IBD based on the current literature and expert opinion. These recommendations include explicit details regarding specific screening tools, timing of screening, and vaccinations for adults with IBD. Conclusions Patients with IBD are at an increased risk for infections, malignancies, and other comorbidities. Given the complexity of caring for patients with IBD, this focused list of recommendations can be easily incorporated in to clinical care to help eliminate the gap in preventative care for patients with IBD.

scholarly journals Azathioprine Has a Deleterious Effect on the Bone Health of Mice with DSS-Induced Inflammatory Bowel Disease

2019 ◽  
Vol 20 (23) ◽  
pp. 6085 ◽  
Author(s):  
Stephanie Morgan ◽  
Kirsty M. Hooper ◽  
Elspeth M. Milne ◽  
Colin Farquharson ◽  
Craig Stevens ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bone Health ◽  
Bowel Disease ◽  
Deleterious Effect ◽  
Recovery Period ◽  
Histopathological Analysis ◽  
Azathioprine Treatment ◽  
Increased Risk ◽  
Significant Difference ◽  
Inflammatory Bowel

Patients with inflammatory bowel disease (IBD) often present poor bone health and are 40% more at risk of bone fracture. Studies have implicated autophagy in IBD pathology and drugs used to treat IBD stimulate autophagy in varying degrees, however, their effect on the skeleton is currently unknown. Here, we have utilised the dextran sulphate sodium (DSS) model of colitis in mice to examine the effects of the thiopurine drug azathioprine on the skeleton. Ten-week-old male mice (n = 6/group) received 3.0% DSS in their drinking water for four days, followed by a 14-day recovery period. Mice were treated with 10 mg/kg/day azathioprine or vehicle control. Histopathological analysis of the colon from DSS mice revealed significant increases in scores for inflammation severity, extent, and crypt damage (p < 0.05). Azathioprine provided partial protection to the colon, as reflected by a lack of significant difference in crypt damage and tissue regeneration with DSS treatment. MicroCT of vehicle-treated DSS mice revealed azathioprine treatment had a significant detrimental effect on the trabecular bone microarchitecture, independent of DSS treatment. Specifically, significant decreases were observed in bone volume/tissue volume (p < 0.01), and trabecular number (p < 0.05), with a concurrent significant increase in trabecular pattern factor (p < 0.01). Immunohistochemical labelling for LC3 revealed azathioprine to induce autophagy in the bone marrow. Together these data suggest that azathioprine treatment may have a deleterious effect on IBD patients who may already be at increased risk of osteoporotic bone fractures and thus will inform on future treatment strategies for patient stratification.

AM:STARs: Clinical GI Challenges in the Adolescent, Vol. 27, No. 1

2016 ◽  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Eating Disorders ◽  
Celiac Disease ◽  
Bone Health ◽  
Bowel Disease ◽  
Transition Of Care ◽  
Health Maintenance ◽  
Functional Gi Disorders ◽  
Inflammatory Bowel

It is now recognized that the prevalence of atopic disorders including (EoE) and immune based conditions such as celiac disease and inflammatory bowel disease are on the rise. This changing epidemiology coupled with advancements in the diagnosis of these conditions have led to greater numbers of adolescents needing treatment. Topics include: Swallowing disorders and eosinophilic esophagitis Celiac and gluten-related disorders Functional GI disorders Advances in inflammatory bowel disease Advances in hepatology Obesity Fad diets, FODMAPS Vitamin D and bone health Gut microbiome and probiotics GI issues in adolescents with eating disorders Health maintenance in adolescents with chronic GI disorders Transition of care

scholarly journals Assessing Cervical Cancer Screening Practices and Preventative Care in Inflammatory Bowel Disease (IBD)

2011 ◽  
Vol 140 (5) ◽  
pp. S-773
Author(s):  
Jill Gaidos ◽  
Shahnaz Sultan ◽  
Judith Simms-Cendan ◽  
I-Chan Huang ◽  
John F. Valentine
Keyword(s):  
Cervical Cancer ◽  
Inflammatory Bowel Disease ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Bowel Disease ◽  
Preventative Care ◽  
Screening Practices ◽  
Inflammatory Bowel

scholarly journals Type of GI Provider Does Not Affect Rates of Vaccination Amongst Inflammatory Bowel Disease Patients

2021 ◽  
Author(s):  
Mehul Trivedi ◽  
Neena Malik ◽  
Joann Kwah
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Vaccination Rate ◽  
Primary Objective ◽  
Bivariate Analysis ◽  
Preventative Care ◽  
Vaccination Rates ◽  
Included Patient ◽  
Significant Difference ◽  
Inflammatory Bowel

Abstract Background:Patients with Inflammatory Bowel Disease (IBD) are at heightened risk of infection, and are often under vaccinated. At our institution, IBD patients may follow up with one of three gastroenterology (GI) providers: IBD specialists, GI Fellows and General GI providers. Aims: Our primary objective was to identify whether the type of GI provider had an effect on rates of vaccinations for IBD patients. The seven vaccines studied were listed in the American College of Gastroenterology’s 2017 Guidelines on Preventative Care in IBD, and include Influenza, Tetanus/Diphtheria/Pertussis, Hepatitis A (HAV), Hepatitis B (HBV), Pneumococcus (PCV13 and PPSV23), Meningococcus, and Human Papillomavirus (HPV).Methods:Retrospective case control study of IBD patients, looking at vaccination rates for each of the seven vaccinations listed above, and type of GI provider followed. Other data collected included patient demographics, IBD type, treatment regimen and insurance.Results:Of 338 IBD patients, 65 (19.2%) followed up with a GI fellow, 110 (32.5%) with a general GI provider, and 163 (48.2%) with an IBD specialist. HBV was the only vaccine with a significant difference in vaccination rate by type of provider. Bivariate analysis showed that patients who followed with IBD specialists and GI fellows were more likely to be vaccinated for HBV than patients who followed up with general GI provider (OR = 2.55, p = .003 and OR = 2.73, p = .007 respectively).Conclusion Type of GI provider only impacted rates of vaccination for HBV among IBD patients in this study, with IBD specialists and GI fellows outperforming general GI providers.

scholarly journals SAT0462 ASSESSMENT OF BONE MINERAL DENSITY IN INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1188.1-1188
Author(s):  
C. Daldoul ◽  
N. El Amri ◽  
K. Baccouche ◽  
H. Zeglaoui ◽  
E. Bouajina
Keyword(s):  
Bone Mineral Density ◽  
Inflammatory Bowel Disease ◽  
Bone Mineral ◽  
Bowel Disease ◽  
Mineral Density ◽  
Femoral Site ◽  
Significant Difference ◽  
History Of ◽  
Inflammatory Bowel ◽  
The Mean

Background:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is considered as a risk factor of low bone mineral density (BMD). In fact, the prevalence of osteoporosis ranges from 17% to 41% in IBD patients. The possible contributing factors may include malabsorption, glucocorticoid treatment and coexisting comorbiditiesObjectives:The purpose of our work was to determine the frequency and the determinants of osteoporosis in patients with IBD and to assess whether there is a difference in BMD status between UC and CD.Methods:This is a retrospective study, over a period of 5 years (from January 2014 to December 2018) and including patients followed for IBD who had a measurement of BMD by DEXA. Clinical, anthropometric and densitometric data (BMD at the femoral and vertebral site) were recorded. The WHO criteria for the definition of osteoporosis and osteopenia were applied.Results:One hundred and five patients were collected; among them 45 were men and 60 were women. The average age was 45.89 years old. The average body mass index (BMI) was 25.81 kg/m2 [16.44-44.15]. CD and UC were diagnosed in respectively 57.1% and 42.9%. A personal history of fragility fracture was noted in 4.8%. Hypothyroidism was associated in one case. Early menopause was recorded in 7.6%. 46.8% patients were treated with corticosteroids. The mean BMD at the vertebral site was 1.023 g/cm3 [0.569-1.489 g/cm3]. Mean BMD at the femoral site was 0.920g/cm3 [0.553-1.286g / cm3]. The mean T-score at the femoral site and the vertebral site were -1.04 SD and -1.27 SD, respectively. Osteoporosis was found in 25.7% and osteopenia in 37.1%. Osteoporosis among CD and UC patients was found in respectively 63% and 37%. The age of the osteoporotic patients was significantly higher compared to those who were not osteoporotic (52.23 vs 43.67 years, p = 0.01). We found a significantly higher percentage of osteoporosis among men compared to women (35.6% vs 18.3%, p=0.046). The BMI was significantly lower in the osteoporotic patients (23.87 vs 26.48 kg/m2, p=0.035) and we found a significant correlation between BMI and BMD at the femoral site (p=0.01). No increase in the frequency of osteoporosis was noted in patients treated with corticosteroids (27.9% vs 21.6%, p=0.479). Comparing the UC and CD patients, no difference was found in baseline characteristics, use of steroids or history of fracture. No statistically significant difference was found between UC and CD patients for osteoporosis(p=0.478), BMD at the femoral site (p=0.529) and at the vertebral site (p=0.568).Conclusion:Osteoporosis was found in 25.7% of IBD patients without any difference between CD and UC. This decline does not seem to be related to the treatment with corticosteroids but rather to the disease itself. Hence the interest of an early screening of this silent disease.Disclosure of Interests:None declared

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&gt;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

Crohn's and colitis: New research offers insights into caring for young people

2020 ◽  
Vol 1 (5) ◽  
pp. 217-218
Author(s):  
Pamela Qualter ◽  
Bernie Carter
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Young People ◽  
Social Interactions ◽  
Bowel Disease ◽  
Disease Symptoms ◽  
Health And Wellbeing ◽  
Close Friendships ◽  
Inflammatory Bowel ◽  
New Research

The unpredictable nature of inflammatory bowel disease symptoms and stigma can affect young people's ability to form close friendships and affect their social interactions. New research shows the importance of addressing the mental health and wellbeing of young people with Crohn's disease and colitis.

scholarly journals Prevalence of mental health disorders in inflammatory bowel disease: an Australian outpatient cohort

2015 ◽  
pp. 197 ◽  
Author(s):  
Simon Knowles ◽  
Davina Tribbick ◽  
Michael Salzberg ◽  
Maria Ftanou ◽  
William Connell ◽  
...  
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Mental Health Disorders ◽  
Inflammatory Bowel ◽  
Health Disorders
Sign in / Sign up

Export Citation Format

Share Document