Nurse-led early evaluation following corticosteroid prescription in patients with inflammatory bowel disease

2021 ◽  
Vol 19 (8) ◽  
pp. 36-41
Author(s):  
Philip R Harvey ◽  
Jayne Slater ◽  
Akram Algieder ◽  
Judith Jones ◽  
Beth Bates ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Care Centre ◽  
Potential Reduction ◽  
Early Evaluation ◽  
Evaluation Group ◽  
Inflammatory Bowel ◽  
Specialist Nurses

Background The Toronto consensus for management of ulcerative colitis (UC) recommends early evaluation of UC patients 2 weeks after initiation on corticosteroids. A system for early evaluation of inflammatory bowel disease patients was established by specialist nurses in a secondary care centre. Aim To compare outcomes following early evaluation to the previous service. Methods All patients undergoing early evaluation over a 1-year period were prospectively audited and compared to a retrospective cohort of patients receiving prednisolone in the preceding year. Findings Of 140 patients included, 76 (54.3%) underwent early evaluation. All patients in the early evaluation group received drug education and details of the nurse helpline (17.1% of patients did not already have this). Of patients, 81.6% were prescribed Adcal, and 83.9% were on 5-aminosalicylates. Fewer admissions were observed within 6 months following early evaluation (8.6% vs. 23.4%, p=0.013). Conclusion Multiple benefits of early evaluation were observed, including a potential reduction in hospital admissions.

Nurse-led early evaluation following corticosteroid prescription in patients with inflammatory bowel disease

2021 ◽  
Vol 3 (12) ◽  
pp. 500-506
Author(s):  
Philip R Harvey ◽  
Jayne Slater ◽  
Akram Algieder ◽  
Judith Jones ◽  
Beth Bates ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Care Centre ◽  
Potential Reduction ◽  
Early Evaluation ◽  
Evaluation Group ◽  
Inflammatory Bowel ◽  
Specialist Nurses

Background: The Toronto consensus for management of ulcerative colitis (UC) recommends early evaluation of UC patients 2 weeks after initiation on corticosteroids. A system for early evaluation of inflammatory bowel disease patients was established by specialist nurses in a secondary care centre. Aim: To compare outcomes following early evaluation to the previous service. Methods: All patients undergoing early evaluation over a 1-year period were prospectively audited and compared to a retrospective cohort of patients receiving prednisolone in the preceding year. Findings: Of 140 patients included, 76 (54.3%) underwent early evaluation. All patients in the early evaluation group received drug education and details of the nurse helpline (17.1% of patients did not already have this). Of patients, 81.6% were prescribed Adcal, and 83.9% were on 5-aminosalicylates. Fewer admissions were observed within 6 months following early evaluation (8.6% vs. 23.4%, p=0.013). Conclusion: Multiple benefits of early evaluation were observed, including a potential reduction in hospital admissions.

scholarly journals The incidence and prevalence of inflammatory bowel disease in UK primary care: a retrospective cohort study of the IQVIA Medical Research Database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karoline Freeman ◽  
Ronan Ryan ◽  
Nicholas Parsons ◽  
Sian Taylor-Phillips ◽  
Brian H. Willis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Practice ◽  
Cohort Study ◽  
Medical Research ◽  
Bowel Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Research Database ◽  
Care Providers ◽  
Inflammatory Bowel

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.

Decreasing Rates of Hospital Admissions for Inflammatory Bowel Disease Between 2000 and 2009

2011 ◽  
Vol 140 (5) ◽  
pp. S-267
Author(s):  
Carlos Taxonera ◽  
Juan L. Mendoza ◽  
Dulce M. Cruz-Santamaría ◽  
Natalia López-Palacios ◽  
Cristina Alba ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Hospital Admissions ◽  
Inflammatory Bowel

scholarly journals P226 Assessing the effectiveness of the nurse navigator role in an inflammatory bowel disease medical home: A retrospective cohort study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S255-S255
Author(s):  
C G Heisler ◽  
K Gawdat ◽  
N Nazer ◽  
M Stewart ◽  
B Currie ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Healthcare System ◽  
Bowel Disease ◽  
Retrospective Cohort Study ◽  
Medical Home ◽  
Retrospective Cohort ◽  
Nurse Navigator ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Patients living with chronic illnesses require long-term and often repeated interactions with the healthcare system. inflammatory bowel disease (IBD) is an incurable, chronic gastrointestinal disease which frequently flares and remits. The nurse navigator (NN) serves as the point of first contact for IBD connecting patients with their multidisciplinary care team in order to facilitate and expedite assessment, treatment and navigation through the healthcare system with the goal of improving disease-related outcomes while reducing healthcare system burden. The aim of this study was to assess the impact of implementation of an IBD NN role within a multidisciplinary IBD Medical home on access to care, disease-related outcomes, patient satisfaction with care, and healthcare resource use. Methods This was a retrospective cohort study comparing an IBD patient population that had access to a 24/7 NN-led helpline to a reference population who did not have access to such a service. Data between August 2017 and October 2019 were extracted from patient charts. Distribution of the number of flares and time to clinical assessment between the NN exposed cohort and a non-NN exposed cohort are planned using multivariate analysis. This is a preliminary description of the NN-exposed cohort only. Results Preliminary results identified a total of 643 patients in the NN-exposed cohort. The majority of our NN-exposed population were female (64.3%). The mean age was 46.42 ± 16.86 years. Sixty-five per cent of patients had CD, 33% UC and 2% IBDU. Of the 729 calls extracted, care coordination (39%) was the most frequent indication for calls followed by flare (25%), and medication education (16%). Patients made the majority (52.8%) of calls compared with NN initiated calls (47.2%). The mean number of calls per patient was 2.64 ± 2.51 (range 1–18) during the study period. Time to clinic assessment post flare call was on average 10.22 ± 8.51 days. Conclusion These results are descriptive of the NN-exposed cohort. Data comparing outcomes amongst the NN-exposed cohort to the non-exposed cohort will be presented at ECCO.

scholarly journals Specialist inflammatory bowel disease nursing in the UK: current situation and future proofing

2020 ◽  
pp. flgastro-2019-101354 ◽  
Author(s):  
Lisa Younge ◽  
Isobel Mason ◽  
Rukshana Kapasi
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Formal Education ◽  
Clinical Nurse Specialists ◽  
Nursing Services ◽  
Business Cases ◽  
Inflammatory Bowel ◽  
Specialist Nurses ◽  
The Uk ◽  
The Impact

ObjectiveTo determine the impact to date of the ongoing Crohn’s & Colitis UK inflammatory bowel disease (IBD) clinical nurse specialists (CNS) campaign.MethodsA survey-based design was used. 2 questionnaires were sent to the UK IBD nursing community and promoted via nursing and clinical networks. Respondents were asked to provide data at both an individual and trust level about their nursing services.Results394 IBD CNS posts were identified across the UK, with a 32% increase in posts since the start of the campaign. 27% felt the campaign had been influential in securing new posts. Greater numbers of posts were reported in England when compared with the devolved nations. Most services remain below the UK standards recommendation of 2.5 IBD CNS per 250 000 patient population. Cross site working was reported in 59% of services. 45% of respondents were non-medical prescribers, with 13% educated to MSc level. High levels of stress were reported by IBD CNS associated with managing advice line services.ConclusionsCrohn’s & Colitis UK’s ‘More IBD Nurses–Better Care’ campaign has contributed to the numbers of CNS posts in IBD continuing to rise, but they remain lower than the recommended standard of 2.5 IBD CNS per 250 000. Educational and career pathways are not clearly defined, and aspects of the role such as advice line provision contribute to stress within the workforce. The ongoing aims of the charity campaign hope to address these issues by improving access to formal education pathways with peer support for IBD specialist nurses, and advice line training, in addition to supporting trusts and services throughout the UK to reduce the workforce deficit with effective business cases.

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