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. 2023 Jun 30;2(7):928-934.
doi: 10.1016/j.gastha.2023.06.009. eCollection 2023.

Healthcare Utilization Patterns and Excessive Steroid Use in Late Adolescence Age and Young Adults With Crohn's Disease and Ulcerative Colitis

Fatima S Hussain  1 , Aniruddh Setya  1 , Isaac Molina  2 , Naueen A Chaudhry  2 , Xiaofei Chi  3 , Matthew J Gurka  3 , Stephanie L Filipp  3 , Angela Pham  4 , David Kerman  5 , Maria T Abreu  5 , Ellen M Zimmermann  2
Affiliations

Healthcare Utilization Patterns and Excessive Steroid Use in Late Adolescence Age and Young Adults With Crohn's Disease and Ulcerative Colitis

Fatima S Hussain et al. Gastro Hep Adv. .

Abstract

Background and aims: Late adolescents and young adults (AYA) with inflammatory bowel disease (IBD) are a vulnerable population as they transition to adult healthcare. We aim to provide a real-world data on their healthcare utilization patterns and medication use through a large database.

Methods: We performed a retrospective cohort study from January 1, 2012, to June 30, 2020, using OneFlorida Data-Trust, an electronic health record-based data repository representing over half of the Florida population. Outcomes of interest included demographics, healthcare utilization, medications, and disease severity. Chi-square tests and logistic regression were used to compare the rates of medication use, healthcare utilization, and disease severity by age groups.

Results: The number of patients who met our inclusion criteria was 10,578 with 2731 (25.8%) in the 17-25-year-old group. AYA patients had fewer ambulatory visits vs children (90% vs 95%; P value <.05). AYA patients were admitted more frequently from emergency facilities vs children (22.3% vs 10.9%; P value <.05). AYA patients received steroids more often than adults and younger patients (48.9% vs 45.3 vs 44.3% P value <.05, respectively). AYA patients received more narcotic (41.1% vs 22.3 % P value <.05) and antidepressant prescriptions (15.9% vs 9.5%; P value <.05) compared with children. With advancing age, a decrease in biologic use was noted (51% vs 40% vs 25.4% P value <.05, respectively).

Conclusion: AYA patients with IBD have higher rates of hospital admissions from emergency department, fewer ambulatory health visits and they receive more steroids compared to children. Our study demonstrates the need for age-specific IBD programs for AYA patients.

Keywords: Access to healthcare; Antidepressants; Biologics; College students; Narcotics.

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References

    1. Ng S.C., Shi H.Y., Hamidi N., et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769–2778. - PubMed
    1. Heyman M.B., Kirschner B.S., Gold B.D., et al. Children with early-onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr. 2005;146(1):35–40. - PubMed
    1. Abramson O., Durant M., Mow W., et al. Incidence, prevalence, and time trends of pediatric inflammatory bowel disease in Northern California, 1996 to 2006. J Pediatr. 2010;157(2):233–239.e1. - PubMed
    1. Baldassano R.N., Piccoli D.A. Inflammatory bowel disease in pediatric and adolescent patients. Gastroenterol Clin North Am. 1999;28(2):445–458. - PubMed
    1. WHO Adolescence age. https://www.who.int/health-topics/adolescent-health#tab=tab_1

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