scholarly journals Defining Quality Indicators for Best-Practice Management of Inflammatory Bowel Disease in Canada

2014 ◽  
Vol 28 (5) ◽  
pp. 275-285 ◽  
Author(s):  
Geoffrey C Nguyen ◽  
Shane M Devlin ◽  
Waqqas Afif ◽  
Brian Bressler ◽  
Steven E Gruchy ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Quality Indicators ◽  
Bowel Disease ◽  
Best Practice ◽  
Group Discussion ◽  
Published Data ◽  
Inflammatory Bowel ◽  
The Impact

BACKGROUND: There is a paucity of published data regarding the quality of care of inflammatory bowel disease (IBD) in Canada. Clinical quality indicators are quantitative end points used to guide, monitor and improve the quality of patient care. In Canada, where universal health care can vary significantly among provinces, quality indicators can be used to identify potential gaps in the delivery of IBD care and standardize the approach to interprovincial management.METHODS: The Emerging Practice in IBD Collaborative (EPIC) group generated a shortlist of IBD quality indicators based on a comprehensive literature review. An iterative voting process was used to select quality indicators to take forward. In a face-to-face meeting with the EPIC group, available evidence to support each quality indicator was presented by the EPIC member aligned to it, followed by group discussion to agree on the wording of the statements. The selected quality indicators were then ratified in a final vote by all EPIC members.RESULTS: Eleven quality indicators for the management of IBD within the single-payer health care system of Canada were developed. These focus on accurate diagnosis, appropriate and timely management, disease monitoring, and prevention or treatment of complications of IBD or its therapy.CONCLUSIONS: These quality indicators are measurable, reflective of the evidence base and expert opinion, and define a standard of care that is at least a minimum that should be expected for IBD management in Canada. The next steps for the EPIC group involve conducting research to assess current practice across Canada as it pertains to these quality indicators and to measure the impact of each of these indicators on patient outcomes.

scholarly journals The Impact of Inflammatory Bowel Disease in Canada 2018: Quality of Life

2018 ◽  
Vol 2 (Supplement_1) ◽  
pp. S42-S48 ◽  
Author(s):  
Jennifer L Jones ◽  
Geoffrey C Nguyen ◽  
Eric I Benchimol ◽  
Charles N Bernstein ◽  
Alain Bitton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
The Impact

Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gil Y. Melmed ◽  
Brant Oliver ◽  
Jason K. Hou ◽  
Donald Lum ◽  
Siddharth Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Quality Of Care ◽  
Health Care Utilization ◽  
Bowel Disease ◽  
Care Program ◽  
Care Utilization ◽  
Inflammatory Bowel

scholarly journals N26 Experiences of patients with inflammatory bowel disease (IBD) regarding faecal incontinence and the guidance received

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
T T I Toivonen ◽  
K Helin ◽  
R Nikkola
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Faecal Incontinence ◽  
Bowel Disease ◽  
Bowel Function ◽  
Health Care Personnel ◽  
Wexner Score ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) suffer more often than the rest of the population from faecal incontinence, which decreases their quality of life. The purpose of this study was to describe the experiences of Finnish IBD patients regarding faecal incontinence and the guidance they need and have received for faecal incontinence. Methods The data were collected by executing focused interviews of eleven IBD patients, who at the time of the interview were in remission. The interviewees participated in the study via the Finnish patient association Crohn ja Colitis ry. The data were analysed using an inductive content analysis. Results Seven participants were men and four were women. They had had IBD for an average of 2 to 40 years. Five interviewees had Crohn’s disease and six had ulcerative colitis. The extent of the faecal incontinence and its impact on quality of life were assessed by Jorge–Wexner score, which examines the frequency of solid and loose stools and intestinal gas, use of diapers or protective pads, and the patients’ perception of the impact on the quality of life. Zero points stands for complete continence and 20 points for complete incontinence. The average Wexner score among participants was 9.8 (Figure 1). The participants felt that faecal incontinence was constantly disturbing their life. They especially wished for support and information regarding diet. Fear of faecal incontinence made participants skip planned activities and isolate themselves at home. Participants tried to anticipate bowel movements and find out toilet locations in advance in order to venture out of their homes. Participants had discussed faecal incontinence with an IBD nurse and a doctor, but none had met a continence nurse. Furthermore, none of the participants had been told about potential faecal incontinence or ways to manage it. Some participants felt that diet had improved their bowel function, although health care personnel had said in their guidance that diet has no effect on faecal incontinence. Participants also felt that they would have needed information regarding the risk of faecal incontinence and wished that they had been heard regarding problems caused by faecal incontinence. Conclusion IBD patients need guidance from health care personnel and information regarding faecal incontinence to balance their bowel function. Health care personnel taking care of IBD patients in Finland needs more training on faecal incontinence, and in addition, more guidance and criteria on when to direct a patient to a continence nurse is needed.

scholarly journals Best Practice Guidance for Adult Infusion Centres during the COVID-19 Pandemic: Report from the COVID-19 International Organization for the Study of IBD [IOIBD] Task Force

2020 ◽  
Vol 14 (Supplement_3) ◽  
pp. S785-S790
Author(s):  
Iris Dotan ◽  
Remo Panaccione ◽  
Gilaad G Kaplan ◽  
Colm O’Morain ◽  
James O Lindsay ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Best Practice ◽  
Online Survey ◽  
Task Force ◽  
International Organization ◽  
Care Givers ◽  
Global Guidance ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Infusion centres are a central part in the management of patients with inflammatory bowel disease [IBD] and could be a source of transmission of SARS-COV-2. Here we aimed to develop global guidance for best practices of infusion centres for IBD patients and to determine the impact of the COVID-19 pandemic on these centres. Under the auspices of the International Organization for the Study of Inflammatory Bowel Disease [IOIBD], a task force [TF] was formed, an online survey was developed to query infusion centre protocols during COVID-19, and recommendations were made, based on TF experience and opinion. Recommendations focus mainly on patients screening, infusion centres re-organization, personnel protection, and protocol modifications such as shortening infusion duration or replacing it with subcutaneous alternatives. Implementing these recommendations will hopefully reduce exposure of both IBD patients and care givers to SARS-COV-2 and improve the function and safety of infusion centres during the COVID-19 pandemic as well as potential future threats.

scholarly journals P262 Trends in the prevalence and severity of anaemia in paediatric patients with inflammatory bowel disease in the last decade

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S281-S281
Author(s):  
S Y Geng ◽  
Z Ridha ◽  
B L Pham ◽  
E Tran ◽  
A Peixoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Disease Severity ◽  
Bowel Disease ◽  
Paediatric Patients ◽  
Intestinal Involvement ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Anaemia is one of the most common extraintestinal manifestations in patients with inflammatory bowel disease(IBD) at diagnosis. Studies have shown that anaemia was associated with low levels of quality of life, which improves with the correction of anaemia in adults. Recent data have shown an increase in the incidence and severity of paediatric IBD. We aim to investigate the trends in the prevalence of anaemia in children at diagnosis of IBD in the last decade. The secondary aim was to investigate the associations between haemoglobin (Hb) levels and disease characteristics. Methods Eligible patients (age ≤18 years, diagnosed with IBD from 2009 to 2018) were retrospectively identified through a prospective IBD database maintained at CHU Sainte-Justine, Montreal, Canada. Disease localisation and phenotype were defined according to the Paris Classification of IBD. Anaemia was defined by Hb levels according to WHO targets. The annual prevalence of anaemia was calculated according to subtype (inflammatory vs. iron deficiency). The Pediatric Crohn’s Disease Activity Index(PCDAI) and the Pediatric ulcerative colitis Activity(PUCAI) Index were used to assess the disease severity at diagnosis. Results We included 887 patients (439 females), mean(SD) age of 13.1 (3.4) years. Of these, 519 (58.5%) were identified with anaemia within 30 days of diagnosis. The median (IQR) Hb level at diagnosis was 108 (98 −114) g/dl. Severe anaemia(< 70 g/dl) was present in 1.8 % of patients. The prevalence of anaemia at diagnosis remained relatively stable ranging from 60.2% in 2009 to 60.4% in 2018. The annual proportion of inflammatory vs. iron-deficiency anaemia is displayed in Figure 1. Anaemia was more prevalent in CD (62.2%) than UC (57.9%) or IBD-U(39.6%). The median(IQR) PCDAI and PUCAI were respectively 37.5 (27.5–47.5) and 55.0 (40.0–65.0) in the anaemic group as compared with 27.5 (20.0–37.50) and 35.0 (25.0–55.0) in the non-anaemic group; p < 0.0001. Patients with anaemia had a lower BMI z-score [median(IQR) −0.84(−1.84–0.08)] than the non-anaemic patients[median(IQR) −0.38(−1.21–0.43)]; p < 0.001. The prevalence of anaemia correlated significantly with disease location: upper intestinal involvement [L4a(67.7%) L4b(63.6%) L4aL4b(60.7%) none (52.8%)] p = 0.024 for CD; for UC[E1(21.1%) E2(44.4%) E3(75.0%) E4 (71.1%)] p < 0.0001. A moderate correlation was found between Hb levels and C-reactive protein (r = −0.312, 95% CI: −0.378 to −0.243, p < 0.0001). Conclusion Anaemia remains a prevalent symptom in paediatric patients with IBD, and it is correlated with the extent of intestinal involvement and disease severity. The impact of anaemia at diagnosis and during follow-up on the levels of quality of life and physical activity is currently under investigation.

scholarly journals Work Productivity Loss in Inflammatory Bowel Disease Patients in Turkey

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Firdevs Topal ◽  
Hakan Camyar ◽  
Elif Saritas Yuksel ◽  
Suleyman Gunay ◽  
Fatih Topal ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Online Survey ◽  
Productivity Loss ◽  
Young Patients ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
The Impact

Background. Beyond the medical treatment in inflammatory bowel disease (IBD), there are other issues which influence the quality of life adversely. The aim of this study was to determine the impact of the IBD patients’ illness on working and education life. Method. The participants were invited to participate in the online survey from the Turkish Crohn’s and Ulcerative Colitis Patient Association network. The data was analysed and then discussed to improve the health-related quality of working and education life. Results. One hundred and fifteen patients had ulcerative colitis (UC) (57.2%), and 86 had Crohn’s disease (CD) (42.8%). There was a statistically significant difference in UC between retirement age group 1 (<40 age) and groups 2 (40-49 ages) and 4 (60-65 ages) (p<0.05). There was the same significant difference in CD. Even though the data did not have significant statistical difference, there was clustering around negative perceptions the patients have about their working and education lives. Conclusion. Our survey revealed a very strong causative relationship between work and IBD involving problems before, during, and at the end of employment. Young patients lower their career expectations, and that announces a clear need to support them and improve career guidance.

Mo1829 - The Impact of Serum Cortisol on Quality of Life and Dysautonomia in Inflammatory Bowel Disease

2018 ◽  
Vol 154 (6) ◽  
pp. S-817
Author(s):  
Benjamin H. Click ◽  
Alyce J. Anderson ◽  
Claudia Ramos Rivers ◽  
Marc Schwartz ◽  
Arthur Barrie ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Serum Cortisol ◽  
Inflammatory Bowel ◽  
The Impact
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