Defining Quality Indicators for Best-Practice Management of Inflammatory Bowel Disease in Canada

Nguyen, Geoffrey C.; Devlin, Shane; Afif, Waqqas; Bressler, Brian; Gruchy, S E; Kaplan, Gilaad G.; Oliveira, Lauro Augusto de; Plamondon, Sophie; Seow, Cynthia H.; Cn, Williams; Wong, Khai Phang; Yan, Brian; Jones, Jennifer

doi:10.1155/2014/941245

Cited by 53 publications

(36 citation statements)

References 155 publications

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“…(44) In these patients, early initiation of corticosteroid-sparing therapies, including thiopurines, methotrexate, and biologics, is recommended to reduce steroid exposure and represent a measure of high-quality IBD care in several guidelines. (44–47)…”

Section: Medical Management In Elderly Ibd Patientsmentioning

confidence: 99%

Management of Inflammatory Bowel Disease in the Elderly Patient

Ananthakrishnan

Donaldson

Lasch

et al. 2017

Inflammatory Bowel Diseases

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The population of older patients with inflammatory bowel disease (IBD) continues to grow, partly reflecting the aging global population in general. The debilitating effects of IBD compound age-related decrements in health and functional capacity, and make the medical management of older patients with Crohn’s disease and ulcerative colitis distinctly challenging to clinicians. Here, we review the recent literature describing the pharmacologic management of IBD in this population, with focus on the safety, tolerability, and efficacy of common treatment options, such as steroids, immunomodulators, tumor necrosis factor-α antagonists, and integrin antagonists; surgical interventions in older patients are also discussed. Few studies have systematically and prospectively evaluated the clinical challenges in the medical management of IBD in this patient population, leaving a limited evidence base to which clinicians can turn to for guidance. Treatment patterns may thus be suboptimal. For example, prolonged steroid use in the elderly was found to be common, causing significant morbidity from side effects in a particularly vulnerable population. Finally, within the context of a limited evidence base, we discuss common treatment scenarios to define the parameters within which physicians can individualize care for older patients with IBD. Overall, older IBD patients are at higher risk of adverse events and less treatment responsiveness compared with younger patients, underscoring the need for future studies to fully characterize appropriate treatment courses for this population.

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Section: Medical Management In Elderly Ibd Patientsmentioning

confidence: 99%

Management of Inflammatory Bowel Disease in the Elderly Patient

Ananthakrishnan

Donaldson

Lasch

et al. 2017

Inflammatory Bowel Diseases

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“…Quality improvement (QI) in medicine is defined as the efforts to change care using an evidence‐based approach in order to make meaningful positive changes to the health care . Clinical quality indicators are quantitative endpoints used to guide, monitor and improve the quality of patient care . The use of QI in IBD is fast growing, and it is becoming increasingly recognised that such measures are important .…”

Section: Details Of Quality Improvement Initiatives In the Paediatricmentioning

confidence: 99%

Quality improvement in paediatric inflammatory bowel disease: the Manitoba experience

El‐Matary

Dufault

2016

Acta Paediatrica

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“…9,[14][15][16] The AGA has developed process measures for IBD which have been used by the federal health insurance program in the United States, Medicare, to provide financial incentives (or avoid financial penalties) for gastroenterologists when caring for patients with IBD. 17 However, these measures are limited in scope and primarily used for accountability and reporting for financial incentives, rather than for QI purposes.…”

Section: Quality Indicatorsmentioning

confidence: 99%

“…14 developed metrics for IBD centers of excellence in Spain; a common theme 16 In addition, a recent effort for the Canadian "Choosing Wisely" campaign to reduce unnecessary or harmful practices has identified 5 aspects of care that should be avoided in patients with IBD; unlike other process measures that recommend appropriate practices, 19 these measures represent processes of poor quality of care.…”

mentioning

confidence: 99%