scholarly journals Surgery, stomas, and anxiety and depression in inflammatory bowel disease: a retrospective cohort analysis of privately insured patients

2019 ◽  
Vol 22 (5) ◽  
pp. 544-553
Author(s):  
L. A. Sceats ◽  
M. S. Dehghan ◽  
K. K. Rumer ◽  
A. Trickey ◽  
A. M. Morris ◽  
...  
Author(s):  
Jéssica Martins Torres ◽  
Gabriela Santos Silva ◽  
Felipe Bertollo Ferreira ◽  
Ana Paula Hamer Sousa Clara ◽  
Felipe Welling Lorentz ◽  
...  

Introdução: A doença inflamatória intestinal (DII) representa um grupo de afecções crônicas idiopáticas que levam à inflamação do intestino. As duas principais representantesdessa doença são a Doença de Crohn (DC) e a Retocolite Ulcerativa (RCU). A crescente incidência e prevalência das doenças inflamatórias intestinais em países em desenvolvimentocomo o Brasil torna cada vez mais necessário o entendimento do comportamento epidemiológico da doença. Objetivo: Este presente estudo tem como objetivo analisar o perfil clínico epidemiológico da doença inflamatória intestinal em hospital de referência para o tratamento dessa patologia. Métodos: Trata-se de um estudo tipo coorte histórica com abordagem quantitativa, realizado no Ambulatório de Gastroenterologia do Hospital Santa Casa de Misericórdia de Vitória (HSCMV) localizado no estado do Espírito Santo. A população estudada foi adquirida após busca no sistema informatizado dos atendimentos hospitalares e ambulatoriais sob o CID-10 K50 e K51 durante o período de 01/01/2010 até 31/12/2019 (N=300). Resultados: A média de idade no momento do diagnóstico da doença inflamatória intestinal foi de 35,1 anos. A análise comparativa das variáveis epidemiológicas mostra que no grupo de DC 67,5% dos participantes tiveram pelo menos uma internação por exacerbação da doença ao longo de seu acompanhamento, contrastando com 28,9% dos portadores de RCU. Em relação a classe de medicamentos, nota-se que o grupo de RCU teve 24,7% dos participantes usando imunobiológicos durante o período analisado, o uso dessemesmo medicamento no grupo de portadores de DC foi de 63,2%. Conclusão: Este trabalho assume sua importância ao trazer dados novos da epidemiologia da DII no estado do Espírito Santo e do comportamento da doença, além de apresentar diferenças importantes da  literatura mundial, se transformando, assim, em um documento de grande importância para o serviço. Palavras chave: Doença de Crohn, Colite ulcerativa, Epidemiologia AbstractIntroduction: Inflammatory bowel disease it’s an idiopathic disorder that leads to inflammation of the gastroenteric tissue. The two main representatitves of this condition areCrohn’s Disease and Ulcerative Colitis. The increasing incidence of this disorder in developing countries such as Brazil makes the understanding of epidemiological aspects increasingly important. Objective: This article aimed to explore the clinical-epidemiological aspects of patients diagnosed with inflammatory bowel disease. Method: It’s a retrospective cohort study. The study design includes the patients diagnosed with inflammatory bowel disease seen at the gastroenterology clinic of the Hospital Santa Casa de Misericórdia de Vitória during January, 2010 to December 2019. Results: The average age at the time of the diagnosis was 35,1 years old. The analysis shows that 67,5% of the patients with Crohn’s Disease (CD) was hospitalized at least one time due to descompensation compared to 28,9% of Ulcerative Colitis (UC) patients. 24,7% of the UC participants made use of immunobiological therapy contrasted with 63,2% of CD patients. Conclusion: This article brings to light new epidemiological data and disease’s behavior regarding inflammatory bowel disease in the state of Espírito Santo besides uncovers important divergences between this study and other articles. This way, it becomes an important tool to the Gastroenterology clinic.   Keyword: Crohn disease, Colitis ulcerative, Epidemiology


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Amir Rumman ◽  
Roberto Candia ◽  
Justina J. Sam ◽  
Kenneth Croitoru ◽  
Mark S. Silverberg ◽  
...  

Background. Antitumor necrosis factor (anti-TNF) therapy is a highly effective but costly treatment for inflammatory bowel disease (IBD).Methods. We conducted a retrospective cohort study of IBD patients who were prescribed anti-TNF therapy (2007–2014) in Ontario. We assessed if the insurance type was a predictor of timely access to anti-TNF therapy and nonroutine health utilization (emergency department visits and hospitalizations).Results. There were 268 patients with IBD who were prescribed anti-TNF therapy. Public drug coverage was associated with longer median wait times to first dose than private one (56 versus 35 days,P=0.002). After adjusting for confounders, publicly insured patients were less likely to receive timely access to anti-TNF therapy compared with those privately insured (adjusted hazard ratio, 0.66; 95% CI: 0.45–0.95). After adjustment for demographic and clinical characteristics, publicly funded subjects were more than 2-fold more likely to require hospitalization (incidence rate ratio [IRR], 2.30; 95% CI: 1.19–4.43) and ED visits (IRR 2.42; 95% CI: 1.44–4.08) related to IBD.Conclusions. IBD patients in Ontario with public drug coverage experienced greater delays in access to anti-TNF therapy than privately insured patients and have a higher rate of hospitalizations and ED visits related to IBD.


2021 ◽  
Vol 160 (6) ◽  
pp. S-335
Author(s):  
Rishabh Shah ◽  
Anoushka Dua ◽  
Bruce D. Naliboff ◽  
Priyam V. Tripathi ◽  
Robert Mocharla ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karoline Freeman ◽  
Ronan Ryan ◽  
Nicholas Parsons ◽  
Sian Taylor-Phillips ◽  
Brian H. Willis ◽  
...  

Abstract Background Our knowledge of the incidence and prevalence of inflammatory bowel disease (IBD) is uncertain. Recent studies reported an increase in prevalence. However, they excluded a high proportion of ambiguous cases from general practice. Estimates are needed to inform health care providers who plan the provision of services for IBD patients. We aimed to estimate the IBD incidence and prevalence in UK general practice. Methods We undertook a retrospective cohort study of routine electronic health records from the IQVIA Medical Research Database covering 14 million patients. Adult patients from 2006 to 2016 were included. IBD was defined as an IBD related Read code or record of IBD specific medication. Annual incidence and 12-month period prevalence were calculated. Results The prevalence of IBD increased between 2006 and 2016 from 106.2 (95% CI 105.2–107.3) to 142.1 (95% CI 140.7–143.5) IBD cases per 10,000 patients which is a 33.8% increase. Incidence varied across the years. The incidence across the full study period was 69.5 (95% CI 68.6–70.4) per 100,000 person years. Conclusions In this large study we found higher estimates of IBD incidence and prevalence than previously reported. Estimates are highly dependent on definitions of disease and previously may have been underestimated.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Glynis Byrne ◽  
Greg Rosenfeld ◽  
Yvette Leung ◽  
Hong Qian ◽  
Julia Raudzus ◽  
...  

Background. Inflammatory bowel disease (IBD) patients are not routinely screened for depression and anxiety despite knowledge of an increased prevalence in people with chronic disease and negative effects on quality of life. Methods. Prevalence of anxiety and depression was assessed in IBD outpatients through retrospective chart review. The presence of anxiety and/or depression was determined using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 self-report questionnaires or by diagnosis through psychiatric interview. Patient demographics, disease characteristics, and medication information were also collected. Multivariable analysis was used to determine associations between patient factors and depression and anxiety. Results. 327 patient charts were reviewed. Rates of depression and anxiety were found to be 25.8% and 21.2%, with 30.3% of patients suffering from depression and/or anxiety. Disease activity was found to be significantly associated with depression and/or anxiety (p=0.01). Females were more likely to have anxiety (p=0.01). Conclusion. A significant proportion of IBD patients suffer from depression and/or anxiety. The rates of these mental illnesses would justify screening and referral for psychiatric treatment in clinics treating this population. Patients with active disease are particularly at risk for anxiety and depression.


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