Improvement of quality of care in inflammatory bowel disease: the role of Steroid Assessment Tool (SAT)-results from a tertiary center trial

Corticosteroids play an important role in the treatment of inflammatory bowel disease patients. They are used for induction of remission but due to their numerous side-effects they are avoided in the long term treatments.In order to improve medical care for the IBD patients guidelines were developed to avoid steroid excess and to promote regular monitoring of corticosteroid use. The aim of this study was to evaluate corticosteroid treatment using an online tool in a tertiary IBD centre from Romania. Methods: An online monitoring tool – SAT (Steroid Assessment Tool) was used to assess disease characteristics, corticosteroid use, corticosteroid excess as defined by international guidelines and the use of bone protection medication associated to steroid treatment. Two successive evaluations of patients treated in a tertiary IBD center were made, the first one in March 2019 on 44 patients and the second one 12 month later, in March 2020, on 84 patients. Data were statistically analyzed with SPSS® software. Results: The results showed that in 2019 the rate of corticosteroid use was of 34%, while in 2020 there was a decrease of corticosteroid use up to 25%. Regarding steroid excess, in 2019 there were 20.4% of patients treated with steroids in excess, but we managed to reduce it to 5.95% in 2020, a decrease that was statistically significant. Bone protection medication was prescribed to only 6.6% of patients treated with corticosteroids in 2019, but a significant increase up to 95% was obtained in 2020. Discussions: Two SAT evaluations of a tertiary IBD centre from Romania revealed that despite new therapeutic options, the rate of steroid use was higher than that reported in other international studies. The objective evaluation of steroid use determined a change in managing IBD patients, thus we succeeded to decrease significantly the rate of steroid excess and increase the use of calcium and vitamin D associated to corticotherapy. Conclusions: The use of an objective tool for monitoring corticosteroid use determined an improvement in managing IBD patients and thus of quality of care.

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Quality of Care in Inflammatory Bowel Disease: the Role of Steroid Assessment Tool (SAT) - a Review

Medicina Moderna - Modern Medicine ◽

10.31689/rmm.2020.27.3.171 ◽

2020 ◽

Vol 27 (3) ◽

pp. 171-176

Author(s):

Loredana GORAN ◽

Monica STATE ◽

Ana NEGREANU ◽

Lucian NEGREANU

Keyword(s):

Inflammatory Bowel Disease ◽

Quality Of Care ◽

Side Effects ◽

Bowel Disease ◽

Maintenance Treatment ◽

Assessment Tool ◽

Web Based ◽

Inflammatory Bowel

Corticosteroids have an important role in induction of remission in inflammatory bowel disease, but they are not an indicated for maintenance treatment as they are associated with many side effects. Despite new effi cient therapeutic options for maintaining remission, there is an excess in prescribing steroids in inflammatory bowel disease. Corticosteroid use was evaluated in international cohorts given that steroid free remission and avoiding serious side-effects of corticosteroids is a desirable goal. We discuss the role and the evidences on a secure web-based steroid assessment tool (SAT) which can be used as an instrument of evaluation of corticosteroid use, a quality indicator in inflammatory bowel disease.

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A86 INFLAMMATORY BOWEL DISEASE PATIENTS’ SATISFACTION WITH TELEHEALTH: DURING THE COVID-19 PANDEMIC

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.084 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 56-57

Author(s):

M Painchaud ◽

S Singh ◽

R M Penner

Keyword(s):

Inflammatory Bowel Disease ◽

Patient Satisfaction ◽

Quality Of Care ◽

Bowel Disease ◽

Online Survey ◽

Ease Of Use ◽

Term Care ◽

Continuous Contact ◽

Inflammatory Bowel

Abstract Background Due to the COVID-19 pandemic, clinics were forced to implement telehealth into clinical practice. Inflammatory bowel disease (IBD) patients are a unique population that require long-term care to achieve and maintain deep remission of disease. Thus, they require stable and continuous contact with healthcare providers, often with multiple appointments. We examined an IBD predominant practice, also providing care for general gastrointestinal (GI) conditions in Kelowna, British Columbia. As telehealth has the potential to become a standard of care for clinics, patient satisfaction must be considered. We hypothesize that with the efficacy and ease of remote appointments, there will be an increase in patient satisfaction, quality of care, and quality of communication. Aims We aim to compare the level of patient satisfaction between in-person appointments pre-pandemic, and current remote appointment telehealth practices. Methods An online survey was sent to the 608 patients who had participated in one or more remote appointment between March 15-June 15, 2020. The survey compared the level of patient satisfaction, quality of care, and quality of communication between patient and doctor before and during the pandemic. It was also determined if patients would elect to continue with remote appointments in the future due to ease of use, and time/financial resources saved. Results Of the 273 participants, 80% were IBD patients while 20% were treated for other GI conditions. A total of 78% reported that they would elect to continue with remote appointments as their primary point of care with their doctor. The remaining 22% reported that they prefer in-person visits due to the necessity of a physical exam, yet specified that communication by these remote means was still of good quality. Levels of patient satisfaction before and during the pandemic remained consistent, where 59% of patients assigned a satisfaction rating of 10 (highest) to their pre-pandemic in-person appointments, and 54% of patients assigned a rating of 10 to their remote appointments during the pandemic. Similar consistent results were found for quality of care and quality of communication. A total of 70% of patients reported that if this service had not been available, they would have sought out other forms of care; 18% of the total responses considering emergency care. Conclusions IBD patients at Kelowna Gastroenterology perceived similar levels of satisfaction, quality of care, and quality of communication with both in-person and telehealth appointments. This suggests that telehealth practices may be a cost-effective, sustainable appointment style that provides comparable quality to in-person appointments. Funding Agencies None

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Indicators of Quality of Care in Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1097/mib.0000000000001069 ◽

2017 ◽

Vol 23 (5) ◽

pp. 702-703 ◽

Cited By ~ 1

Author(s):

Wael El-Matary

Keyword(s):

Inflammatory Bowel Disease ◽

Quality Of Care ◽

Bowel Disease ◽

Inflammatory Bowel

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Quality of care indicators in inflammatory bowel disease in a tertiary referral center with open access and objective assessment policies

Digestive and Liver Disease ◽

10.1016/j.dld.2017.09.137 ◽

2018 ◽

Vol 50 (1) ◽

pp. 37-41 ◽

Cited By ~ 4

Author(s):

Lorant Gonczi ◽

Zsuzsanna Kurti ◽

Petra Anna Golovics ◽

Barbara Dorottya Lovasz ◽

Orsolya Menyhart ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Quality Of Care ◽

Open Access ◽

Bowel Disease ◽

Objective Assessment ◽

Tertiary Referral ◽

Tertiary Referral Center ◽

Assessment Policies ◽

Inflammatory Bowel

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Crohn's & Colitis Australia inflammatory bowel disease audit: measuring the quality of care in Australia

Internal Medicine Journal ◽

10.1111/imj.14187 ◽

2019 ◽

Vol 49 (7) ◽

pp. 859-866 ◽

Cited By ~ 8

Author(s):

Wayne Massuger ◽

Gregory T. C. Moore ◽

Jane M. Andrews ◽

Monique F. Kilkenny ◽

Megan Reyneke ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Quality Of Care ◽

Bowel Disease ◽

Crohn’S Colitis ◽

Crohn's Colitis ◽

Inflammatory Bowel

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Is Digital Health Intervention Effective in Inflammatory Bowel Disease Patients?

Kompass Nutrition & Dietetics ◽

10.1159/000519080 ◽

2021 ◽

pp. 1-2

Author(s):

Bilge Roj Gunerhanal ◽

Merve Guney-Coskun

Keyword(s):

Inflammatory Bowel Disease ◽

Quality Of Care ◽

Health Monitoring ◽

Bowel Disease ◽

Digital Health ◽

Management Strategies ◽

Care Quality ◽

Technological Advances ◽

Inflammatory Bowel

Technological advances now permit self-management strategies using mobile applications which could greatly benefit patient care. The purpose of this study was to investigate whether the use of the inflammatory bowel disease (IBD) digital health monitoring platform, HealthPROMISE, leads to better quality of care and improved health outcomes in IBD patients. IBD patients were recruited in gastroenterology clinics and asked to install the HealthPROMISE application onto their smartphones. Patient satisfaction, quality of care, quality of life, patient symptoms, and resource utilization metrics were collected throughout the study and sent directly to their healthcare teams. Patients with abnormal symptom/SIBDQ scores were flagged for their physicians to follow up. After one-year, patient outcome metrics were compared to baseline values. Overall, out of 59 patients enrolled in the study, 32 patients (54%) logged into the application at least once during the study period. The number of IBD-related ER visits/hospitalizations in the year of use compared to the prior year demonstrated a significant decrease from 25% of patients (8/32) to 3% (1/32) (p = 0.03). Patients also reported an increase in their understanding of the nature/causes of their condition after using the application (p = 0.026). No significant changes were observed in the number of quality indicators met (p = 0.67) or in SIBDQ scores (p = 0.48). Given the significant burden of IBD, there is a need to develop effective management strategies. This study demonstrated that digital health monitoring platforms may aid in reducing the number of ER visits and hospitalizations in IBD patients.

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