Underdiagnosis and Undertreatment of Migraine in Italy: A Survey of Patients Attending for The First Time 10 Headache Centres

Cephalalgia ◽  
2009 ◽  
Vol 29 (12) ◽  
pp. 1285-1293 ◽  
Author(s):  
S Cevoli ◽  
D D'Amico ◽  
P Martelletti ◽  
F Valguarnera ◽  
E Del Bene ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Healthcare Utilization ◽  
Short Form ◽  
Poor Quality ◽  
Current Therapy ◽  
Previous Diagnosis ◽  
Headache Diagnosis ◽  
First Time ◽  
Headache Centres

The aim of this study was to asses the clinical features, pattern of healthcare and drug utilization of migraine patients attending 10 Italian headache centres (HC). Migraine is underdiagnosed and undertreated everywhere throughout the world, despite its considerable burden. Migraine sufferers often deal with their problem alone using self-prescribing drugs, whereas triptans are used by a small proportion of patients. All patients attending for the first time 10 Italian HCs over a 3-month period were screened for migraine. Migraine patients underwent a structured direct interview about previous migraine diagnosis, comorbidity, headache treatments and their side-effects and healthcare utilization for migraine. Patient satisfaction with their usual therapy for the migraine attack was evaluated with the Migraine-Assessment of Current Therapy (ACT) questionnaire. The quality of life of migraine patients was assessed by mean of Short Form (SF)-12 and Migraine-Specific Quality of life (MSQ) version 2.1 questionnaires. Of the 2675 patients who attended HCs for the first time during the study period, 71% received a diagnosis of migraine and the first 953 subjects completed the study out of 1025 patients enrolled. Only 26.8% of migraine patients had a previous diagnosis of migraine; 62.4% of them visited their general practitioner (GP) in the last year, 38.2% saw a specialist for headache, 23% attended an Emergency Department and 4.5% were admitted to hospital for migraine; 82.8% of patients used non-specific drugs for migraine attacks, whereas 17.2% used triptans and only 4.8% used a preventive migraine medication. Triptans were used by 46.4% of patients with a previous diagnosis of migraine. About 80% of migraine patients took over-the-counter medications. The Migraine-ACT revealed that 60% of patients needed a change in their treatment of migraine attacks, 85% of whom took non-specific drugs. Both the MSQ version 2.1 and the SF-12 questionnaires indicated a poor quality of life of most patients. Migraine represents the prevalent headache diagnosis in Italian HCs. Migraine is still underdiagnosed in Italy and migraine patients receive a suboptimal medical approach in our country, despite the healthcare utilization of migraine subjects being noteworthy. A cooperative network involving GPs, neurologists and headache specialists is strongly desirable in order to improve long-term migraine management in Italy.

A Modern Review of the Operative Management of Chronic Pancreatitis

2010 ◽  
Vol 76 (10) ◽  
pp. 1071-1074 ◽  
Author(s):  
Jonathan C. King ◽  
Shannon Abeywardina ◽  
James J. Farrell ◽  
Howard A. Reber ◽  
O. Joe Hines
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Short Form ◽  
Operative Management ◽  
Poor Quality ◽  
Whipple Procedure ◽  
Life Questionnaire ◽  
Historical Controls

Chronic pancreatitis is a debilitating disease resulting in pain, intestinal malabsorption, endocrine dysfunction, and poor quality of life (QoL). Our aim was to analyze surgical outcomes for patients with chronic pancreatitis. Data for patients undergoing operations for chronic pancreatitis between 1990 and 2009 were reviewed. Demographics, operative and perioperative data, and survival were catalogued. QoL was determined (Short Form 36 and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire + PAN-26) and compared with historical controls. The mean age was 51 ± 2 years, 38 patients were male (53%), the most common indication was pain (71%), the etiology of pancreatitis often was alcohol, and most patients underwent a Whipple procedure (56%). Operative time was 316 ± 17 minutes and blood loss was 363 ± 75 mL. There were 34 complications in 30 patients (42%) and one death. QoL surveys were administered for 25 of 55 (45%) surviving patients at a mean follow-up of 72 ± 16 months. Mean survival was 99 ± 9 months, whereas 5- and 10-year survival were 86 and 75 per cent. QoL scores were uniformly better than historical controls. Our data demonstrate that operations for chronic pancreatitis can be performed with acceptable morbidity and mortality. Patients have excellent survival and improved QoL compared with historical controls. Surgery is an effective and durable treatment option for patients with chronic pancreatitis.

Functional Impairment of Patients Undergoing Surgical Correction for Charcot Foot Arthropathy

2017 ◽  
Vol 38 (7) ◽  
pp. 705-709 ◽  
Author(s):  
Ellen Kroin ◽  
Adam Schiff ◽  
Michael S. Pinzur ◽  
Elissa S. Davis ◽  
Edwin Chaharbakhshi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Comparative Investigation ◽  
Poor Quality ◽  
Charcot Foot ◽  
Level Of Evidence ◽  
Short Musculoskeletal Function Assessment ◽  
Operative Correction ◽  
The Impact

Background: Investigations using the Medical Outcomes Study Short Form 36 Healthy Survey (SF-36) and the American Orthopaedic Foot & Ankle Society Diabetic Foot Questionnaire (AOFAS-DFQ) have demonstrated a poor quality of life in patients with Charcot foot arthropathy. The Short Musculoskeletal Function Assessment (SMFA) questionnaire has been widely used in patients with a broad range of musculoskeletal disorders. Methods: Twenty-five consecutive patients undergoing operative correction for diabetes-related Charcot foot arthropathy of the midfoot completed the SMFA prior to undergoing surgery. There were 16 males and 9 females. The average body mass index (BMI) was 37.4 (range 25.8-50.2), and the average hemoglobin A1c was 7.5 (range 5.3-10.1) prior to surgery. Results: All 25 patients exhibited significant impairment in all 6 domains of the SMFA ( P < .0001) as compared to the normative data. There was a high correlation between each of the 6 domains of the SMFA, even after correcting for BMI. Conclusion: Charcot foot severely impaired the quality of life in patients beyond the impact of morbid obesity. This impairment equally impacted all of the functional and emotional domains measured with the SMFA as compared with population norms. This investigation provides a benchmark for measuring the impact of operative correction of the deformity. In addition, the SMFA appears to be a valid tool for measuring impairment in this complex patient population. Level of Evidence: Level II, prospective comparative investigation

scholarly journals Psychiatric morbidity, quality of life and marital satisfaction among spouse of men with opioid dependence syndrome: a study from North India

2017 ◽  
Vol 4 (2) ◽  
pp. 556
Author(s):  
Ruchi Soni ◽  
Ritesh Upadhyay ◽  
Parth Singh Meena ◽  
Mahendra Jain
Keyword(s):  
Quality Of Life ◽  
Marital Satisfaction ◽  
Psychiatric Disorder ◽  
Opioid Dependence ◽  
Short Form ◽  
Psychiatric Morbidity ◽  
Poor Quality ◽  
North India ◽  
Significant Difference

Background: Opioid dependence syndrome has deleterious consequences not only on addict but also on the members of family especially his spouse who is most vulnerable to develop significant psychiatric disorder given the intimate nature of their relationship. Addressing these issues will be beneficial as spouses are important source of moral support and assistance to the substance user’s quest toward abstinence.Methods: For psychiatric morbidity, 100 spouses of men with opioid dependence syndrome were evaluated. Severity of opioid dependence in the husbands was assessed using severity of opioid dependence questioner (SODQ). Quality of life and marital satisfaction was assessed using short form health survey 36 (SF 36) and marital satisfaction scale (MSS) respectively.Results: Data analysis reveals that 33% of spouses had a psychiatric disorder. Primarily mood and anxiety disorder was present in 22% and 9% of subjects respectively. Highly significant difference existed between cases and controls in terms of marital satisfaction (p = 0.0001) and quality of life (p≤0.05) indicating low marital satisfaction and poor quality of life in spouses of opioid dependent individuals.Conclusions: Psychological distress and psychiatric morbidity in spouses of opioid dependent men is high, with poor quality of marital life and marital satisfaction being low. Hence, interventions that aim at allaying their distress and improving their mental health can improve the condition of the substance user and contribute to a better outcome of substance abuse treatment.

scholarly journals The Association Between Multimorbidity and Health-Related Quality of Life Among Clients Attending Chronic Outpatient Medical Care in Bahir Dar, Northwest Ethiopia: The Application of Partial Proportional Odds Model

2021 ◽  
Author(s):  
Fantu Abebe Eyowas ◽  
Marguerite Schneider ◽  
Shitaye Alemu ◽  
Sanghamitra Pati ◽  
Fentie Ambaw Getahun
Keyword(s):  
Quality Of Life ◽  
Medical Care ◽  
Short Form ◽  
Poor Quality ◽  
Northwest Ethiopia ◽  
Proportional Odds Model ◽  
Bahir Dar ◽  
Proportional Odds ◽  
Partial Proportional Odds Model

Abstract Background Multimorbidity, the presence of two or more chronic non-communicable diseases (NCDs) in a given person affects all aspects of individuals’ lives. Poor quality of life (QoL) is one of the major consequences of living with multimorbidity. Although healthcare aims to support multimorbid individuals to achieve better quality of life, little is known about the effect of multimorbidity on quality of life of patients attending chronic outpatient medical care in Ethiopia. Objectives This study aimed to determine the association between multimorbidity and quality of life among clients attending chronic outpatient medical care in Bahir Dar city, Northwest Ethiopia. Methods A multi-centered facility-based study was conducted among 1440 participants aged 40+ years attending chronic outpatient medical care. Two complementary methods (interview and review of medical records) were employed to collect data on sociodemographic characteristics and presence of chronic diseases. We used the short form (SF-12 V2) instrument to measure quality of life. The data were analyzed by STATA V.16 and multivariate partial proportional odds model was fitted to identify covariates associated with quality of life, adjusting for relevant confounding factors. Statistical significance was considered at p-value <0.05.Results Multimorbidity was identified in 54.8% (95% CI=52.2%-57.4%) of the sample. A significant proportion (33.5%) of the study participants had poor quality of life and one fourth (25.8%) of them had moderate quality of life. Advanced age and living with multimorbidity were associated with poor quality of life. Conversely, being female, strong social support, high socioeconomic status, and adequate functioning and satisfaction with care were the variables positively associated with higher categories of quality of life.Conclusion The magnitude of multimorbidity in this study was high and individuals living with multimorbidity had a relatively poor quality of life than those without multimorbidity. Care of people with chronic multiple conditions may need to be oriented to the realities in multimorbidity burden and its implication on quality of life. Interventions targeting modifiable associated factors and studies exploring the longitudinal effect of multimorbidity on quality of life are needed.

scholarly journals HUBUNGAN TINGKAT DEPRESI DAN KUALITAS HIDUP PADA PASIEN GAGAL JANTUNG KRONIK DI POLIKLINIK JANTUNG RSUP PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Christin Tatukude ◽  
Starry H. Rampengan ◽  
Agnes L. Panda
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Beck Depression Inventory ◽  
Short Form ◽  
Functional Limitation ◽  
Poor Quality ◽  
Short Form 36 ◽  
Consecutive Sampling

Abstract: Heart failure is the major cause of morbidity and mortality worldwide. Heart failure is defined as heart’s inability to pump the blood to supply oxygen and nutrients to the body’s tissues. Functional limitation and psychological distress such as depression caused by this chronic condition will affect the quality of life of patients. This study aimed to determine the relationship of the level of depression and quality of life of patients with chronic heart failure. This was an observational analytical study with a cross sectional approach. Samples were 38 patients with chronic heart failure obtained by using consecutive sampling method. The level of depression was measured by using the Beck Depression Inventory-II meanwhile the quality of life was measured by using the Short Form-36. The results showed that of the 15 respondents with minimal depression, 4 respondents had poor quality of life and 11 respondents had better quality of life; of the 16 respondents with mild depression, 13 respondents had poor quality of life and 3 respondents had better quality of life, meanwhile 5 respondents with moderate depression and two respondents with severe depression had poor quality of life. Conclusion: There was a significant relationship between the level of depression and the quality of life. The higher the level of depression the poorer the quality of life of patients with chronic heart failure.Keywords: chronic heart failure, levels of depression, quality of life  Abstrak: Gagal jantung merupakan penyebab utama morbiditas dan mortalitas di seluruh dunia. Gagal jantung didefinisikan sebagai ketidakmampuan jantung memompa darah untuk memenuhi kebutuhan oksigen dan nutrisi jaringan tubuh. Keterbatasan fungsional dan distres psikologis seperti kejadian depresi yang disebabkan kondisi kronis ini akan mempengaruhi kualitas hidup pasien. Tujuan penelitian ini yaitu untuk mengetahui hubungan tingkat depresi dan kualitas hidup pada pasien gagal jantung kronik. Penelitian ini menggunakan metode analitik observasional dengan pendekatan potong lintang. Sampel penelitian adalah 38 pasien gagal jantung kronik yang diambil menggunakan teknik consecutive sampling. Tingkat depresi diukur menggunakan kuesioner Beck Depression Inventory-II dan kualitas hidup diukur menggunakan kuesioner Short Form-36. Hasil penelitian menunjukkan dari 15 responden dengan depresi minimal terdapat empat responden memiliki kualitas hidup kurang baik dan 11 responden memiliki kualitas hidup baik, kemudian dari 16 responden dengan depresi ringan terdapat 13 responden memiliki kualitas hidup kurang baik dan tiga responden memiliki kualitas hidup baik, sementara lima responden dengan depresi sedang dan dua responden dengan depresi berat memiliki kualitas hidup kurang baik. Simpulan: Terdapat hubungan bermakna antara tingkat depresi dan kualitas hidup, dimana semakin tinggi tingkat depresi maka semakin rendah kualitas hidup pasien gagal jantung kronik.  Kata kunci: gagal jantung kronik, tingkat depresi, kualitas hidup

scholarly journals Kualitas Hidup Pasien Hipertensi Dengan Penyakit Penyerta Di Poli Jantung RSUD Ratu Zalecha Martapura

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Riza Alfian ◽  
Yugo Susanto ◽  
Siti Khadizah
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Heart Failure ◽  
Short Form ◽  
Life Quality ◽  
Poor Quality ◽  
Average Score ◽  
Emotional Condition ◽  
Diabetes Melitus

ABSTRAK Hipertensi dengan penyakit penyerta adalah salah satu penyebab kematian nomor satu di dunia. Hal tersebut pasti akan membahayakan jiwa pasien dan menurunkan kualitas hidup pasien. Kualitas hidup merupakan indikator penting untuk menilai keberhasilan intervensi pelayanan kesehatan, baik dari segi pencegahan maupun pengobatan. Tujuan penelitian ini adalah untuk mengetahui gambaran kualitas hidup pasien hipertensi dengan penyakit penyerta gagal jantung dan hipertensi dengan penyakit penyerta diabetes melitus di poli jantung RSUD Ratu Zalecha Martapura. Penelitian ini merupakan penelitian deskriptif. Pengambilan data dilakukan secara prosfektif pada pasien rawat jalan di poli jantung selama periode Desember 2015 – Januari 2016. Subjek penelitian yang memenuhi kriteria inklusi sejumlah 71 orang yang terbagi atas 58 orang (82,36 %) pasien hipertensi dengan penyakit penyerta gagal jantung dan 13 orang (17,64 %) pasien hipertensi dengan penyakit penyerta diabetes melitus. Pengumpulan data dilakukan dengan melakukan wawancara mengunakan kuesioner Short Form 36 (SF 36). Hasil penelitian menunjukkan untuk 58 orang pasien hipertensi dengan penyakit penyerta gagal jantung 15 orang (25,86%) kualitas hidup baik, dan 43 orang (74,14%) kualitas hidup kurang baik, total skor kualitas hidup rata-rata yaitu 46,21 dengan nilai skor tiap dimensi yaitu fungsi fisik 48,71, fungsi emosi 64,9, fungsi sosial 50,25, kesehatan umum 44,11, keadaan fisik 31,9, keadaan emosi 36,23, dimensi nyeri 36,85, dan fatique 58,72. Sedangkan untuk 13 orang pasien hipertensi dengan penyakit penyerta diabetes melitus 9 orang (69,23 %) kualitas hidup baik dan 4 orang (30,77 %) kualitas hidup kurang baik, total skor kualitas hidup rata-rata yaitu 67,93 dengan nilai skor tiap dimensi yaitu fungsi fisik 69,54, fungsi emosi 86,00, fungsi sosial 75,96, kesehatan umum 49,68, keadaan fisik 63,46, keadaan emosi 66,67, dimensi nyeri 61,92, dan fatique 70,19. Berdasarkan hasil penelitian di poli jantung RSUD Ratu Zalecha Martapura dapat disimpulkan bahwa pasien hipertensi dengan penyakit penyerta gagal jantung mayoritas memiliki gambaran kualitas hidup yang kurang baik dan pasien hipertensi dengan penyakit penyerta diabetes melitus mayoritas memiliki gambaran kualitas hidup baik. Kata Kunci— Kualitas Hidup, Hipertensi dengan penyakit penyerta, ABSTRACT Hypertension with the followers disease is one of the main causes of death in the world. This problem certainly will endanger patients’ life and decrease their life quality. Life quality is an important indicator to measure the successful of health service intervention, either from prevention aspect or medical treatment aspect. The purpose of this research is to know the description of hypertension patient’s life quality with the followers disease heart failure and hypertension with the followers disease diabetes mellitus at polyclinic cardiology of Ratu Zalecha Hospital Martapura. This research is a descriptive research. Collecting data was conducted prosfectively on outpatient at poly cardiology from December 2015 until January 2016. The research subject who fulfilled the inclusive criteria is 71 patients. 58 patients (82.36%) have hypertension with the followers disease heart failure and 13 patients (17.64%) have and hypertension with the followers disease diabetes mellitus. Collecting data was done by doing interview using Short Form questioner (SF36). The result shows that from 58 hypertension patient with the followers disease heart failure, 15 patients of them (25.86%) have a good quality of life and 43 patients (74.14%) have a poor quality of life. The total average score of life quality is 46,21 with each detail aspect score like, physical function 48,71 emotional function 64.9, social function 50.25, general health 44.11, physical condition 31.9, emotional condition 36.23, painful aspect 36.85 and fatigue 58.72. Whereas for 13 hypertension patients with the followers disease diabetes mellitus, 9 (69.23%) of them have a good quality of life and 4 patients (30.77%) have a poor quality of life. The total average score of life quality is 67.93 with each detail aspect like; physical function 69.54, emotional function 86.00, social function 75.96, general health 49.68, physical condition 63.46, emotional condition 66.67, painful aspect 61,92 and fatigue 70,19. Based on the research at polyclinic cardiology of Ratu Zalecha Hospital Martapura it can be concluded that hypertension with the followers disease heart failure majority have poor quality of life and hypertension with the followers disease diabetes mellitus majority have good life of quality Keywords— Quality of life, Hypertension with complication, polyclinic cardiology.

scholarly journals New opportunities for treatment of severe bronchial asthma: from clinical studies to portraits of patients

2015 ◽  
Vol 12 (3) ◽  
pp. 51-61
Author(s):  
N M Nenasheva
Keyword(s):  
Quality Of Life ◽  
Severe Asthma ◽  
Bronchial Asthma ◽  
Significant Proportion ◽  
Poor Quality ◽  
New Class ◽  
Definition Of ◽  
First Time

The proportion of patients with controlled asthma has increased over the last 15 years, however, still there is a significant proportion of patients who do not achieve control of the disease, and therefore have a high risk of exacerbations, hospitalizations, and poor quality of life. Patients with severe asthma, for which there were limited additional pharmacotherapy are the major problem. For the first time in recent years in the treatment of asthma a new class of drugs appeared: longacting anticholinergics - tiotropium which had been entered in stepwise therapy of asthma by GINA 2015. The definition of severe asthma, the role of the cholinergic nervous system in bronchial asthma, mechanism of action and clinical efficacy of tiotropium in severe bronchial asthma adults are described in the article.

scholarly journals 4527 Assessing Quality of Life, Depression, and Symptomatology in Puerto Rican Hispanic Patients Hospitalized with Heart Failure

2020 ◽  
Vol 4 (s1) ◽  
pp. 75-76
Author(s):  
Ariel Gonzalez-Cordero
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Puerto Rico ◽  
Puerto Rican ◽  
Short Form ◽  
Public Health Problem ◽  
Poor Quality ◽  
Life Assessment ◽  
Quality Of Life Assessment

OBJECTIVES/GOALS: Heart failure is a public health problem. Currently, heart failure affects 2-5 % of adults within the age of 65-75 years. (Mosterd & Hoes, 2007)Moreover, rates of hospitalization and rehospitalization among patients with heart failure are high and are associated with poor quality of life(Dunlay et al., 2011)Unsurprisingly, studies have found that poor quality of life is linked to decreased physical activity and increased symptomatology, a perception that can quickly change depending on the patient’s mood. Factors such as age, cultural background, socioeconomical status, ethnicity, and gender are highly correlated with quality of life but have not been studied thoroughly. Quality of life assessment in Puerto Rican Hispanics living with heart failure is non-existent. Objective:•To determine gender-specific differences in quality of life for patients hospitalized due to heart failure in Puerto Rico.•To correlate heart failure symptoms, presence of depression and level of perceived quality of life in Puerto Rican patients hospitalized due to heart failure METHODS/STUDY POPULATION: We will recruit patients admitted with heart failure (n = 300) to the Cardiovascular Hospital of Puerto Rico and The Caribbean between 2019-2021. In the first aim, we will implement the Minnesota Living with Heart Failure Questionnaire to assess the quality of life of Puerto Rican Hispanics diagnosed that life with heart failure and the short form-36 (SF-36) for a generic quality of life assessment. For the second aim, we will provide two instruments: The Geriatrics DepressionScale QuestionnaireShort Form (GDS-SF)and the Memorial Symptom Assessment ScaleShort Form (MSAS-SF) to assess the presence and severity of depression and multiple general symptoms RESULTS/ANTICIPATED RESULTS: We expect that women living with heart failure will have worse quality of life and higher NYHA scale and NT-pro-BNP. DISCUSSION/SIGNIFICANCE OF IMPACT: This contribution is significant because it can clarify the specific risk factors in the Puerto Rican community that are associated with lower quality of life among patients suffering from heart failure. This, in term, can allow physicians to identify which population of HF patients is at risk,and have strategies to improve quality of life

scholarly journals Functional Impairment of Patients Undergoing Surgical Correction for Charcot Foot

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Michael Pinzur ◽  
Adam Schiff ◽  
Ellen Kroin
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Poor Quality ◽  
Surgical Correction ◽  
Charcot Foot ◽  
Medical Outcomes ◽  
Significant Impairment ◽  
American Orthopaedic ◽  
The Impact

Category: Diabetes Introduction/Purpose: Investigations using the Medical Outcomes Study Short Form 36 Healthy Survey (SF-36) and the American Orthopaedic Foot and Ankle Society Diabetic Foot Questionnaire (AOFAS-DFQ) have demonstrated a poor quality of life in patients with Charcot Foot arthropathy. The Short Musculoskelatal Function Assessment (SMFA) questionnaire has been widely used in patients with a broad range of musculoskeletal disorders. Methods: Twenty-five consecutive patients undergoing surgical correction for diabetes-related Charcot Foot Arthropathy of the midfoot completed the Short Musculoskeletal Functional Assessment (SMFA) prior to undergoing surgery. There were 16 males and 9 females. The average BMI was 37.35 (range 25.83-50.22), and the average Hemoglobin A1C was 7.54 (range 5.3-10.1) prior to surgery. Results: All twenty-five patients exhibited significant impairment in all six domains of the SMFA (p<0.0001) as compared to the normative data. There was a high correlation between each of the six domains of the SMFA, even after correcting for BMI. Conclusion: Charcot foot severely impairs quality of life in impacted patients beyond the impact of morbid obesity. This impairment equally impacts all of the functional and emotional domains measured with the SMFA as compared with population norms. This investigation provides an excellent benchmark for measuring the impact of surgical correction. In addition, the SMFA appears to be a valid tool for evaluating this complex patient population.

scholarly journals 2162

2017 ◽  
Vol 1 (S1) ◽  
pp. 70-70
Author(s):  
Alyce J. M. Anderson ◽  
Claudia Ramos-Rivers ◽  
Benjamin Click ◽  
Debbie Cheng ◽  
Ioannis Koutroubakis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Disease Severity ◽  
Healthcare Utilization ◽  
Poor Quality ◽  
Antibiotic Exposure ◽  
Related Quality ◽  
The Impact ◽  
Clinic Visits

OBJECTIVES/SPECIFIC AIMS: Inflammatory bowel disease (IBD) patients are at an increased risk of Clostridium difficile infection (CDI) but the impact of CDI on disease severity is unclear. The aim of this study was to determine the effect of CDI on long-term disease outcome in a cohort of IBD patients. METHODS/STUDY POPULATION: We analyzed patients enrolled in a prospective IBD natural history registry. Patients who tested positive at least once formed the CDI positive group. We generated a 2:1 propensity matched control cohort based on risk factors of CDI in the year before infection. Healthcare utilization data (emergency department use, subsequent hospitalizations, telephone encounters), medications, labs, disease activity, and quality of life metrics were temporally organized. RESULTS/ANTICIPATED RESULTS: A total of 198 patients (66 CDI, 132 matched controls) were included [56.6% female; 60.1% Crohn’s disease (CD), 39.9% ulcerative colitis (UC)]. Groups were not significantly different in the year before infection in all metrics but in the year of infection, having CDI was significantly associated with more steroid and antibiotic exposure, elevated C-reactive protein or erythrocyte sedimentation rate, and low vitamin D (all p<0.01). Infection was associated with increased disease activity metrics (UC: p=0.036, CD: p=0.003), worse disease-related quality of life (p=0.003), and increased healthcare utilization (p<0.001). In the next year after infection those with prior CDI continued to have increased exposure to vancomycin or fidaxomicin (p<0.001) and all other antibiotics (p=0.01). They also continued to have more clinic visits (p=0.006), telephone encounters (p=0.001), and worse disease-related quality of life (p=0.03), but disease activity and biomarkers of severity were not significantly different between groups. DISCUSSION/SIGNIFICANCE OF IMPACT: CDI infection in IBD is significantly associated with various surrogate markers of disease severity, increased healthcare utilization and poor quality of life during the year of infection. CDI patients continue to experience poor quality of life after infection with increased clinic visits and antibiotic exposure while disease activity is no longer significantly increased. These findings suggest that CDI infection may have a lasting effect on healthcare utilization beyond the acute treatment period.

Sign in / Sign up

Export Citation Format

Share Document