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. 2022 Apr 27;7(2):104-117.
doi: 10.1159/000524741. eCollection 2022 Jul.

Therapy Patterns and Surveillance Measures of Inflammatory Bowel Disease Patients beyond Disease-Related Hospitalization: A Claims-Based Cohort Study

Caroline Bähler  1 , Beat Brüngger  1 , Eva Blozik  1 , Stephan R Vavricka  2   3 , Alain M Schoepfer  4
Affiliations

Therapy Patterns and Surveillance Measures of Inflammatory Bowel Disease Patients beyond Disease-Related Hospitalization: A Claims-Based Cohort Study

Caroline Bähler et al. Inflamm Intest Dis. .

Abstract

Introduction: Medical care and surveillance of inflammatory bowel disease (IBD) patients have been shown to be far from satisfactory. Data on therapy patterns and surveillance measures in IBD patients are scarce. We, therefore, aimed to compare the therapy patterns and surveillance management of IBD patients in the year before and after IBD-related hospitalization.

Methods: We examined medical therapy, surveillance management (influenza vaccination, dermatologist visits, Pap smear screening, creatinine measurements, iron measurements, and ophthalmologist visits) and healthcare utilization in 214 ulcerative colitis (UC) and 259 Crohn's disease (CD) patients who underwent IBD-related hospitalization from 2012 to 2014.

Results: IBD-related drug classes changed in 64.5% of IBD patients following hospitalization. During the 1-year follow-up period, biological treatment increased in UC and CD patients, while steroid use decreased. Following hospitalization, 63.1% of UC and 27.0% of CD patients received 5-ASA. Only 21.6% of all IBD patients had a flu shot, and 19.6% of immunosuppressed IBD patients were seen by a dermatologist in the follow-up; other surveillance measures were more frequent. Surveillance before hospital admission and consultations by gastroenterologists were strongly correlated with surveillance during the postoperative follow-up, while gender and diagnosis (UC vs. CD) were not. During the 1-year follow-up, 20.5% of all IBD patients had no diagnostic or disease-monitoring procedure.

Discussion/conclusion: Surveillance measures for IBD patients are underused in Switzerland. Further research is needed to examine the impact of annual screenings and surveillance on patient outcomes.

Keywords: Biologics; Healthcare utilization; Inflammatory bowel disease; Surveillance.

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Figures

Fig. 1
Fig. 1
Monthly changes in IBD-related drug classes prior to and post hospitalization in UC patients.
Fig. 2
Fig. 2
Monthly changes in IBD-related drug classes prior to and post hospitalization in UC patients with (=surgical) and without (=medical) a disease-related surgery at index hospitalization.
Fig. 3
Fig. 3
Monthly changes in IBD-related drug classes prior to and post hospitalization in CD patients.
Fig. 4
Fig. 4
Monthly changes in IBD-related drug classes prior to and post hospitalization in CD patients with (=surgical) and without (=medical) a disease-related surgery at index hospitalization.
Fig. 5
Fig. 5
Number of patients undergoing recommended surveillance measures in the year following IBD-related hospitalization.
See this image and copyright information in PMC

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