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Comparative Study
. 2016 Jun;10(6):759-66.
doi: 10.1586/17474124.2016.1169920. Epub 2016 Apr 12.

Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home

Freddy Caldera  1 , Sumona Saha  1 , Arnold Wald  1 , David M Cooley  2 , Ying-Qi Zhao  3 , Zhanhai Li  3 , Christie M Bartels  4
Affiliations
Comparative Study

Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home

Freddy Caldera et al. Expert Rev Gastroenterol Hepatol. 2016 Jun.

Abstract

Background: Rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) patient populations face similar risks of chronic immunosuppression including corticosteroid use. We compared the receipt of preventive services between IBD and RA populations according to published quality metrics.

Methods: We defined a single-center cohort of patients with IBD or RA receiving specialty and primary care. Electronic health record abstraction assessed quality metrics, sociodemographics, comorbidity, and utilization. Comparisons used multivariate odds ratios and Student's t-tests.

Results: 218 RA and 190 IBD patients were included. In multivariate analysis, IBD patients were less likely to receive pneumococcal vaccination (OR=0.29, 95% CI: 0.11-0.85), while RA patients underwent glucocorticoid-induced osteoporosis screening more often (100% vs. 82.5%, p = 0.023).

Conclusions: Gastroenterologists can improve care quality for IBD patients by assuming greater responsibility for preventive care in IBD patients and/or collaborating with primary care and health systems to improve preventive care delivery.

Keywords: Inflammatory bowel disease; preventive care; quality care; rheumatoid arthritis; vaccination.

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Conflict of interest statement

Declaration of interest

The project described was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR000427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. CM Bartels received support from National Institutes of Health (NIH) National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) (K23 #AR062381) and also receives support from Independent Grants for Learning and Change (Pfizer). S Saha is a consultant with UCB Biosciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1
Figure 1
Flowchart of RA and IBD patient study inclusion and exclusion.
See this image and copyright information in PMC

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