scholarly journals Predictors of Medication Adherence in Pediatric Inflammatory Bowel Disease Patients at the Stollery Children’s Hospital

2009 ◽  
Vol 23 (12) ◽  
pp. 811-815 ◽  
Author(s):  
L Kitney ◽  
JM Turner ◽  
D Spady ◽  
B Malik ◽  
W El-Matary ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Chart Review ◽  
Disease Duration ◽  
Herbal Medicines ◽  
Adherence Rate ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Inflammatory Bowel

BACKGROUND: Patients with inflammatory bowel disease (IBD) often do not take their medications as prescribed.OBJECTIVE: To examine self-reported adherence rates in IBD patients at the Stollery Children’s Hospital (Edmonton, Alberta) and to determine predictors of medication adherence.METHODS: A survey was mailed to 212 pediatric IBD patients of the Stollery Children’s Hospital. A chart review was completed for those who returned the survey.RESULTS: A total of 119 patients completed the survey. The nonresponders were significantly older than responders (14.5 years versus 13.2 years; P=0.032). The overall adherence rate was 80%. Nonadherence was associated with older age (14.6 years versus 13.0 years; P=0.04), longer disease duration (5.0 years versus 3.1 years; P=0.004) and reported use of herbal medications (40.0% versus 13.6%; P=0.029). The most common reasons reported for missing medications were forgetfulness, feeling better and too many medications. In addition, patients reported being more likely to take anti-inflammatory medications and less likely to take herbal medicines.CONCLUSION: Identified predictors of nonadherence such as age, disease duration and use of herbal treatments may enable the development of specific strategies to improve adherence in adolescents with IBD.

Imaging Trends and Radiation Exposure in Pediatric Inflammatory Bowel Disease at an Academic Children's Hospital

2013 ◽  
Vol 201 (1) ◽  
pp. W133-W140 ◽  
Author(s):  
Jason G. Domina ◽  
Jonathan R. Dillman ◽  
Jeremy Adler ◽  
Emmanuel Christodoulou ◽  
Shokoufeh Khalatbari ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Radiation Exposure ◽  
Bowel Disease ◽  
Children's Hospital ◽  
Pediatric Inflammatory Bowel Disease ◽  
Children’S Hospital ◽  
Inflammatory Bowel

scholarly journals P725 Trends in biologic use prior to resective surgery for inflammatory bowel disease: A Canadian population-based study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S583-S584
Author(s):  
D Chopra ◽  
E Kennedy ◽  
A V Weizman ◽  
A Tennakoon ◽  
L E Targownik
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Duration ◽  
Biologic Therapy ◽  
Demographic Data ◽  
Biologic Agent ◽  
Primary Role ◽  
Resective Surgery ◽  
Inflammatory Bowel ◽  
Incident Cases

Abstract Background Despite advances in medical therapy for inflammatory bowel disease (IBD), surgery is required in 50–80% of patients with Crohn’s disease (CD) and 20–30% of patients with ulcerative colitis (UC). Given that fibrostenotic disease may be playing a primary role in patients undergoing resective surgery, practices around biologic administration in this setting need to be clarified. We aimed to describe the pre-operative trends in biologic utilisation for IBD patients undergoing resective surgery. Methods The University of Manitoba IBD Epidemiology Database was used to identify all persons with IBD who underwent resective surgery between April 2005 and 2018. Demographic data were extracted to explore the baseline characteristics of persons on biologic therapy prior to IBD resective surgery. Proportion calculations were used to assess how often a new biologic agent was initiated within 3, 6, and 12 months prior to resective surgery. Results were stratified by type of IBD (UC vs. CD) and disease duration (<3 or ≥3 years) for incident cases. Results A total of 1412 IBD-related resective surgeries were identified from April 2005 to 2018. 67.1% of resective surgeries were performed for CD and 32.9% for UC. Results of analysis are presented below: Conclusion Overall, in Manitoba, rates of biologic initiation or re-start in the pre-operative period for IBD resective surgery are relatively small. Biologic therapy was initiated or re-started more frequently for CD than UC, and when disease duration was less than 3 years. This is reassuring and suggests that physicians are rarely choosing to initiate biologic therapy in futile situations. Work should be performed to see if these findings can be replicated in other practice settings.

Su1801 One Simple Question Is Sufficient for Measuring Medication Adherence in Inflammatory Bowel Disease Patients Using Self-Report

2016 ◽  
Vol 150 (4) ◽  
pp. S556
Author(s):  
Mirjam Severs ◽  
Marie-Josée J. Mangen ◽  
Herma H. Fidder ◽  
Mirthe E. Van Der Valk ◽  
Mike Van Der Have ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Self Report ◽  
Simple Question ◽  
Inflammatory Bowel

scholarly journals FOXP3+T Regulatory Cell Modifications in Inflammatory Bowel Disease Patients Treated with Anti-TNFαAgents

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Luisa Guidi ◽  
Carla Felice ◽  
Annabella Procoli ◽  
Giuseppina Bonanno ◽  
Enrica Martinelli ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Bowel Disease ◽  
Flow Cytometry ◽  
Bowel Disease ◽  
Peripheral Blood ◽  
Disease Duration ◽  
Healthy Controls ◽  
T Regulatory Cell ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Treg modulation has been hypothesized as one of the mechanisms by which antitumor necrosis factorα(TNFα) agents exert their action in rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). However, data in IBD are still conflicting. We evaluated CD4+CD25+FOXP3+(Tregs) by flow cytometry in peripheral blood from 32 adult IBD patient before (T0) and after the induction of anti-TNFαtherapy (T1). Eight healthy controls (HCs) were included. We also evaluated the number of FOXP3+cells in the lamina propria (LP) in biopsies taken in a subset of patients and controls. Treg frequencies were significantly increased in peripheral blood from our patients after anti-TNFαtherapy compared to T0. T1 but not T0 levels were higher than HC. The increase was detectable only in clinical responders to the treatment. A negative correlation was found among delta Treg levels and the age of patients or disease duration and with the activity score of Crohn’s disease (CD). No significant differences were found in LP FOXP3+cells. Our data suggest the possibility that in IBD patients the treatment with anti-TNFαmay affect Treg percentages and that Treg modifications may correlate with clinical response, but differently in early versus late disease.

scholarly journals Endoscopic Stricturotomy Is an Efficacious Option for Management of Strictures in Patients With Inflammatory Bowel Disease

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Nabeeha Mohy-ud-din ◽  
Gursimran S Kochhar
Keyword(s):  
Inflammatory Bowel Disease ◽  
Success Rate ◽  
Bowel Disease ◽  
Chart Review ◽  
Common Complication ◽  
Technical Success ◽  
Technical Success Rate ◽  
Safe Technique ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Strictures are a common complication for patients with inflammatory bowel disease. Endoscopic stricturotomy (ESt) is a novel procedure for treatment of these strictures. Methods A chart review was performed for patients with strictures who underwent ESt. Results Eleven patients were included in the study and the total number of strictures treated was 12. The mean length of the strictures was 10.25 ± 4.36 mm. Technical success was achieved in 92% (n = 11) of the procedures. Postprocedural bleeding occurred in 9% (n = 1) of patients, and none of the patients had complications of infection or perforation. Conclusions ESt is a safe technique with high technical success rate.

A Behavioral Intervention Increases Medication Adherence in Inflammatory Bowel Disease (IBD) Patients: A Prospective Study

2017 ◽  
Vol 152 (5) ◽  
pp. S123
Author(s):  
Philip Oppong Twene ◽  
Francis Farraye ◽  
Tanvi A. Dhere ◽  
Cameron B. Body ◽  
Rachel Patzer ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Prospective Study ◽  
Behavioral Intervention ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
A Prospective Study

scholarly journals P255 Predictors of postoperative morbidity in patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S277-S278
Author(s):  
N Imperatore ◽  
L Pellegrini ◽  
L Bucci ◽  
A Rispo ◽  
A D Guarino ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Wound Infection ◽  
Anastomotic Leak ◽  
Bowel Disease ◽  
Disease Duration ◽  
Intestinal Resection ◽  
Operative Morbidity ◽  
Urinary Infections ◽  
Inflammatory Bowel ◽  
Surgery Duration

Abstract Background More than half of patients suffering from inflammatory bowel disease (IBD) requires surgery in their lifetime. However, predictors of post-operative morbidity and mortality are poorly investigated. Our aim was to assess the predictors of post-operative mortality and morbidity in IBD. Methods retrospective cohort study enrolling all IBD subjects followed-up and operated at our tertiary IBD Centre from 2015 to 2018. For each patient, we evaluated patient-dependent (comorbidities, smoking, drugs, nutritional status), disease-dependent (disease duration, location, behaviour, extension), surgery-dependent variables (duration, emergency/election, laparoscopy/laparotomy, bowel/colic resection, length of intestinal resection). Results 158 subjects were operated during the period study (males 53.8%, Crohn’s disease 75.3%, mean age 41.9 + 16.2, disease duration 109.5 + 98.3 months); the majority (83%) underwent an elective surgery. No patient died. About morbidity, 40 (25.3%) developed post-operative complications: wound infection (8.9%), respiratory complications (6.9%), prolonged ileum (5.1%), anastomotic leak (3.2%), urinary infections (3.2%), abdominal abscess (3.2%), anastomotic bleeding (3.2%), other infections (2.5%), abdominal bleeding (1.9%), obstruction (1.3%). Two subjects (1.3%) required re-operation within 30 days. A surgery-duration <142 min was predictive for a better post-operative outcome (sensitivity 80%, specificity 42%, PPV 32%, NPV 85.9%). At binary logistic regression, stricturing/fistulizing behaviour (OR 3.7, 95% CI 1.6–6.4, p = 0.02), need for total parenteral nutrition (OR 4.1, 95% CI 2.4–9.2, p = 0.01), pre-operative bowel cleansing (OR 0.6, 95% CI 0.4–0.8, p = 0.01), surgery duration <142 min (OR 0.2, 95% CI 0.08–0.7, p = 0.03), were the only predictors for post-operative morbidities. A pre-operative BMI<24 was also predictive for anastomotic leak (OR 4.3, 95% CI 1.8–8.6, p = 0.02); pre-operative hypoalbuminemia was predictive for urinary infections (OR 2.5, 95% CI 1.8–7.9, p = 0.04); pre-operative infliximab was predictive for pneumonia (OR 3.8, 95% CI 2.2–6.3, p = 0.01); diabetes (OR 5.7, 95% CI 2.3–9.8, p < 0.01) and pre-operative steroids (OR 6.1, 95% CI 1.8–11.4, p < 0.01) were predictors of wound infection; need for TPN predicted prolonged ileum (OR 6.1, 95% CI 2.3–15.3, p = 0.03). Conclusion about a quarter of IBD patients undergoing surgery develops a post-operative complication, especially infective. Several patient-related, disease-related and surgery-related factors are predictive for post-operative morbidity. The recognition of these factors, as well the multidisciplinary approach (gastroenterologists, surgeons and nutritionists), and intensive preoperative management could be able to minimise these complications.

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