Navigation Links
Do patients with inflammatory bowel disease receive optimal care?
Date:2/22/2008

Inflammatory bowel disease (IBD) is a chronic recurrent gastrointestinal disease. The disease has a relatively higher morbidity in young adults, in whom growth, education, employment and wellbeing all are adversely influenced. A number of guidelines for management of inflammatory bowel disease are available for bringing evidence-based medicine into full play to improve IBD patient care. What about the actual quality of care for patients with IBD in China?

An article to be published on January 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Jian-Min Si from Zhejiang University, China, conducted a retrospective review of medical therapy for a hospital based-cohort of patients with IBD, involving 71 patients with Crohn's disease (CD) and 106 with ulcerative colitis (UC). Medical therapy including use of oral aminosalicylates, topical therapy, corticosteroid agents and immunomodulatory agents were analyzed.

This article reported that all the patients with ulcerative colitis received optimal doses of aminosalicylate while 39.7% patients with ileal or colonic CD were suboptimal dosed. The incidence of suboptimal dose of aminosalicylate was significantly higher in CD patients with small intestine involvement only. This phenomenon may be explained by the relatively lower incidence of CD than that of UC in China and therefore less understanding of this disease.

Another finding is that only half of the patients with active distal or left-sided ulcerative colitis received topical therapy. There is a tendency to think topical therapy is less effective in clinical practice, quite reverse to the evidence. In fact, its lower efficacy may be due to the lack of preparations, such as liquid enemas, foams, gels and suppositories, rather than due to the medication itself.

More than a quarter of patients who suffered from severe IBD did not receive oral or intravenous steroid therapy, which is possibly due to the lack of comprehensive evaluation of the patients' baseline states and re-evaluation when exacerbations occurred. In addition, the patients' and even some physicians' fear of adverse effects played a part role.

The most striking finding in this study pertains to the use of immunomodulatory drugs. Among the patients for whom immunomodulatory agents were indicated, only one fifth received these drugs. And half of the patients who received azathiopurine were suboptimal dosed in the absence of leucopenia of hepatotoxicity. The limited use of immunomodulatory drugs may be due to the lack of evidence and limited experience with these drugs in Han nationality Chinese with IBD. Uncertainty regarding the risk for neutropenia deters some physicians from using AZA at effective doses for longer periods of treatment.

The results of this study suggest the quality of care for IBD patients can be further improved. Larger prospective studies are needed to investigate the quality of care for patients with IBD and the association of the reported quality of care with patient outcomes.


'/>"/>

Contact: Jing Zhu
wjg@wjgnet.com
0086-105-908-0039
World Journal of Gastroenterology
Source:Eurekalert

Related medicine news :

1. Patients relatives are ignored by the health system and suffer emotional stress
2. Giving Patients a Lift
3. Doctors should watch for depression in arthritis patients
4. Standard test for blood sugar control not accurate in diabetic dialysis patients
5. Warning! Doctors, Insurers Hold Patients Hostage! Says Top Acupuncture Physician
6. Hospital for Special Surgery shares best practices to benefit of British patients
7. HIV patients still stung by stigma from health-care providers
8. Siblings of schizophrenia patients display subtle shape abnormalities in brain
9. Pain Relief Network Sues to Halt Government Actions Taken Against Kansas Patients
10. Good Outcomes Possible for Older Lung Transplant Patients
11. FTCR: Gov. Schwarzenegger Must Follow Through on Call to Ban Blue Cross From Using Doctors as Double-Agents to Dump Sick Patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... Orion, Clarkston, Michigan (PRWEB) , ... June 26, ... ... with respect to fertility once they have been diagnosed with endometriosis. These women ... intercourse but they also require a comprehensive approach that can help for preservation ...
(Date:6/25/2016)... ... ... First Choice Emergency Room , the largest network of independent freestanding ... of its new Mesquite-Samuell Farm facility. , “We are pleased to announce Dr. ... James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. , Dr. ...
(Date:6/24/2016)... ... ... A recent article published June 14 on E Online details ... to state that individuals are now more comfortable seeking to undergo not only the ... and cheek reduction. The Los Angeles area medical group, Beverly Hills Physicians (BHP) notes ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. ... The attorneys chosen by their peers for this recognition are considered among the top ... Shareholders received special honors as members of this year’s Legal Elite Hall of Fame: ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine presented ... in Emergency Medicine conference in Ponte Vedra Beach, FL. The awards honor the ... Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , “With this award, ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... One of Australia,s successful biotechnology ... a new biotechnology company, Noxopharm Limited [ABN 50 608 966 123] ... to list on the ASX. Noxopharm is a clinic-ready ... a Phase 1 clinical study later this year. ... the biggest problems facing cancer patients - the ability of cancers ...
(Date:6/26/2016)... Jazz Pharmaceuticals plc (Nasdaq: JAZZ ... Antitrust Improvements Act of 1976, as amended ("HSR"), with ... ("Celator"; Nasdaq: CPXX ) expired effective June ... As previously announced on May 31, 2016, Jazz ... under which Jazz Pharmaceuticals has commenced a tender offer ...
(Date:6/26/2016)... OTTAWA, Ontario , June 27, 2016  VMS ... the Company,s Board will take whatever measures required to ... the Company,s stock which is currently listed on the ... S Wexler, Company Chairman and CEO, "We are seeing ... be difficult to understand, not only by the Company, ...
Breaking Medicine Technology: