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:2/22/2017)... ... 22, 2017 , ... Our high-octane society demands higher stands ... brain. , Power On, a mental performance enhancer from Modus Nutrition, provides scientifically ... capsule contains Cognizin® Citicoline, a branded form of the brain health nutrient citicoline ...
(Date:2/22/2017)... (PRWEB) , ... February 22, 2017 , ... The ... to the thousands of individuals who have recently fallen victim to America’s opioid epidemic. ... in Orange County, California, where they are free from the shame, stigma, and ...
(Date:2/22/2017)... ... February 22, 2017 , ... South Bend’s Lunkerville, the award-winning TV series that ... On The Water (HOW), a non-profit organization dedicated to helping military veterans relax, rehabilitate, ... ‘Mike D’ traveling to Lake Denmark, New Jersey, to fish with war veteran Justin ...
(Date:2/22/2017)... ... February 22, 2017 , ... In a 2012 survey, over ... not filling a prescription because they could not afford to pay for it. ... were 30-60%*. At the same time, hospitals, pharmacies, manufacturers and nursing ...
(Date:2/22/2017)... ... 22, 2017 , ... Sideline Products participated in the World Horse Expo held ... Seay and his production crew. Tom Seay’s program “Best of America by Horseback” ... Saddle Sidekicks will be featured on April 6, 2017. After the broadcast, the clip ...
Breaking Medicine News(10 mins):
(Date:2/23/2017)... Mass. , February 23, 2017 - ...   ... Honoring Rare Disease Day Open to All at http://www.shire.com/RareCount   ... today announced the launch of ,Rare Count, in honor of Rare ... diseases, which equates to nearly one in 20 global citizens. It ...
(Date:2/22/2017)... , Feb. 22, 2017 IRIDEX Corporation (Nasdaq: ... release financial results for the fourth quarter and 2016 ... 2017.  The Company,s management team will host a corresponding ... p.m. ET. Investors interested in listening to ... 707-0665 for domestic callers or (703) 326-3030 for international ...
(Date:2/22/2017)... , Feb. 22, 2017 Summary ... deals and agreements entered into by the worlds leading ... Description The Global Spinal Cord Partnering Terms ... to partnering deals and agreements entered into by the ... partnering deals - Top deals by value ...
Breaking Medicine Technology: