Anemia Screening, Prevalence, and Treatment in Pediatric Inflammatory Bowel Disease in the United States, 2010–2014

Abstract

PurposeWe examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD).MethodsA retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010–2014. Children (ages 1–21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex.ResultsThe cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia.ConclusionAt least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%–50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

The burden and management of anemia in Greek patients with inflammatory bowel disease: a retrospective, multicenter, observational study

“…This percentage is higher than what was previously referred in the literature ( 22 ) and even better than what is recorded in pediatric IBD patients. Although a more meticulous approach is expected in pediatric patients, Miller et al mentioned ferritin measurement only 1 out of 5 anemic pediatric IBD patients ( 26 ).…”

Human-Centered Design of a Clinical Decision Support for Anemia Screening in Children with Inflammatory Bowel Disease

“…5 Guideline-based IBD IDA care involves annual screening for anemia and treatment with iron when deficiency is present, but adherence to guidelines is often poor. 6,7 Clinical decision support systems (CDSSs) integrated into electronic health records (EHRs) provide an opportunity to deliver evidence-based recommendations that are well integrated into systems of care. [8][9][10][11] Human-centered design (HCD) has been applied to the development of CDSS [12][13][14][15] to improve integration of CDSS tools into clinical workflows and to improve usability with the goals of improving patient safety, enhancing clinical outcomes, and improving process efficiency, among other aims.…”

Iron Deficiency Anaemia and Anaemia of Inflammation in Enteropathies Caused by Commonest Small Intestine Disorders: Current Evidence

“…Another study (Miller et al, 2019) on anaemia prevalence in paediatric IBD included a cohort of 2446 patients and 1560 with CrD. Approximately, 85% of CrD cases were screened for anaemia.…”