scholarly journals PTH-135 An inflammatory bowel disease-specific nutrition screening tool (IBD-NST) for better outpatient care

Author(s):  
Catherine Wall ◽  
Bridgette Wilson ◽  
Jeremy Sanderson ◽  
Miranda Lomer
2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S54-S54
Author(s):  
Therezia AlChoufete ◽  
Siobhan Proksell ◽  
Marc Schwartz ◽  
Cassie Myers ◽  
Emily Weaver ◽  
...  

Abstract Background As management of Inflammatory Bowel Disease (IBD) advances, the outpatient (OP) population is shifting its fears from risks of malnutrition to those associated with over-nutrition and under-nutrition, lack of diet education, access to resources, mental health implications, and socioeconomic status. Failure to identify a patient at nutrition risk could lead to increased costs of care which can be avoided by proper nutrition screening and counseling with a Registered Dietitian (RD). The integration of nutrition counseling into the interdisciplinary care model for patients with IBD needs to be optimized to identify a broader range of risks to nutrition status in an efficient and objective format that can be applied universally in the OP IBD setting. Aims This study 1) explores a novel approach to nutrition risk screening within the OP IBD setting using an interdisciplinary team approach; and 2) evaluates correlations between an objective scoring method for biological and psychosocial risk with nutrition risk scores reported by an RD. Methods Two objective nutrition risk scoring methods were developed to capture biological (NUTR-OBJ) and lifestyle (NUTR-WELL) nutrition factors on a 0–6 scale (low-severe risk). Scores were determined using review of the electronic health record and a screening tool provided to patients. These scores were compared to the previously established IBD Biopsychosocial Complexity Grid, a tool which organizes this health information into biological and psychological domains and serves as the basis for algorithm-driven treatment plans within an IBD Medical Home. Results Data from 44 patients (mean age:35.2 years;47.7% female;56.8% Crohn’s Disease) were included in this study. BMI ranged from 18.08 to 37.92 kg/m2. BIO-C-PRO (mean=1.95,SD 1.86) and BIO-C-OBJ (mean 1.59, SD 1.76) indicate mild overall disease risk within our sample. NUTR-OBJ scores (mean=2.39, SD 1.28) showed no significant correlations with biological (BIO-C-PRO/OBJ) or psychosocial (PSY-C/H;SOC-SES;MI-C) scores. NUTR-WELL (mean=1.98,SD 1.36) showed strong positive correlations with PSY-C (r=.326, p<.05), PSY-H (r=.386,p<.01), SOC-SES (r=.306,p<.05), and MI-C (r=.473,p<.01). Discussion This study indicates a significant correlation between NUTR-WELL scores and psychosocial scores, suggesting validity for this nutrition screening tool to determine behaviors that may increase nutrition risk. Poor correlations between NUTR-OBJ and biological scores suggests that the need for nutrition intervention may not always be indicated by disease severity. This scoring system can potentially serve as a guide to maximize efficiency of follow-up appointments with an RD and avoid complications of care related to poor nutrition status that may be unidentified by disease risk alone. Further research is needed to confirm findings and extend to a larger sample.


2021 ◽  
Vol 3 (1) ◽  
pp. 23-28
Author(s):  
Laura Appleton ◽  
Andrew S. Day

Insufficient disease-related knowledge can be a barrier to the effective management of the unpredictable and lifelong course of inflammatory bowel disease (IBD). Patients with chronic illnesses have high non-adherence rates, with direct clinical consequences. While no single intervention strategy can improve the adherence of all patients, the success of attempts to improve patient adherence depends upon the realistic assessment of patients’ knowledge and their understanding of the regimen. The aim of this study was to assess the disease-specific knowledge of the parents and patients with IBD in the South Island of New Zealand, and identify areas of poor knowledge. Families of children diagnosed with IBD were asked to complete the IBD Knowledge Inventory Device (IBD-KID). Patients 10 years and older were asked to participate along with their parents. Of 110 families, 91 responded, with completed questionnaires received from 153 parents and 66 patients. Overall, parents scored significantly higher (13.64 ± 3.88) than their children (10.03 ± 4.07; p < 0.001). Areas of poor knowledge included aspects of treatment (both conventional and alternative), along with long-term disease outcomes. This study has shown clear areas of concern in this population’s disease-specific knowledge of their disease. This should be addressed through targeted education for both the patient and the parents to improve not only their knowledge, but also their adherence and disease self-management.


2016 ◽  
Vol 25 (12) ◽  
pp. 649-660 ◽  
Author(s):  
Sue Woodward ◽  
Lesley Dibley ◽  
Sarah Combes ◽  
Andrew Bellamy ◽  
Calum Clark ◽  
...  

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S192-S193
Author(s):  
A Busacca ◽  
G Ingrassia Strano ◽  
E Giuffrida ◽  
L Guida ◽  
B Scrivo ◽  
...  

Abstract Background Data on prevalence of extraintestinal manifestations (EIMs) in inflammatory bowel disease (IBD) range from 6% up to 47%. Recently, several red flags and questionnaires have been proposed for early diagnosis of articular manifestations. Our aim was to analyse the prevalence of EIMs in a single-centre prospective cohort, using a comprehensive questionnaire developed by our group to detect all EIMs (EMAIL questionnaire). Methods Patients with IBD attending our Clinic from November 2017 to January 2019 were interviewed using a two-part questionnaire, the first part for clinical-demographic data and the second part for EIMs. Patients positive to screening were referred for multidisciplinary approach. Results Two hundred and six IBD patients were interviewed, 114 (55.3%) Crohn’s disease (CD) and 92 (44.7%) ulcerative colitis (UC), 52.4% male, mean age 46.7 years (SD ± 15,2). Sixty (53%) CD patients and 48 (52%) UC patients, in total 108, had history of at least one EIM. Articular EIMs were found in 49 patients (24%); peripheral arthritis was found in 14% (29/206), axial arthritis in 9.7% (20 patients): seven patients (3.4%) had ankylosing spondylitis, 13 (6.3%) sacroiliitis. Cutaneous EIMs were detected in 39 patients (19%), erythema nodosum in 15 patients (7.3%), pyoderma gangrenosum in 9 (4.4%), psoriasis in 15 (7.3%) and folliculitis in 7 (3.4%). Ocular EIMs were observed in 35 patients (17%): uveitis in 7 patients (3.4%), conjunctivitis in 8 (3.9%), optic neuritis in 2, glaucoma in 2 patients, cataract in 13 (6,3%), dry eye in 4 (1.9%), central serous chorioretinopathy in 1. Hepatobiliary EIMs were observed in 31 patients (15%): 26 steatosis (12.6%), 5 (2.4%) primary sclerosing cholangitis. Four (2%) patients had DVT. Articular EIMs were more frequent in CD patients (p = 0.001). Skin manifestations were more frequent in female (p = 0.002) in CD (p = 0,032) and related with IBD activity (&lt;0.001). Hepatobiliary manifestations were more frequent in male (p = 0,017) and in UC (p = 0,044). There was a significant correlation between DVT and IBD activity (p = 0,016). Conclusion The questionnaire developed by our group proved to be a sensitive screening tool. Articular and cutaneous EIMs are more frequent in CD, hepatobiliary EIMs are more frequent in UC. A gender difference has been found since cutaneous EIMs are more frequent in females, hepatobiliary more in males. Cutaneous EIMs and DVT are related with IBD activity.


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