International variation in medication prescription rates among elderly patients with inflammatory bowel disease

Benchimol, Eric I; Cook, Suzanne F.; Erichsen, Rune; Long, Millie D.; Bernstein, Çharles N.; Wong, Jenna; Carroll, Charlotte F.; Frøslev, Trine; Sampson, Tim; Kappelman, Michael D.

doi:10.1016/j.crohns.2012.09.001

Cited by 64 publications

(42 citation statements)

References 29 publications

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“…Because of a lack of desirable efficacy and poor tolerability of these drugs, surgical intervention may be indicated 94,95. The healthcare utilization associated with IBD is different between nations and appears related to sociodemographic factors 69,96–100. In the US, healthcare costs are higher than in any other country 97.…”

Section: Resultsmentioning

confidence: 99%

Inflammatory Bowel Disease: An Expanding Global Health Problem

M’Koma

2013

Clin Med Insights Gastroenterol

261

225

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This review provides a summary of the global epidemiology of inflammatory bowel diseases (IBD). It is now clear that IBD is increasing worldwide and has become a global emergence disease. IBD, which includes Crohn’s disease (CD) and ulcerative colitis (UC), has been considered a problem in industrial-urbanized societies and attributed largely to a Westernized lifestyle and other associated environmental factors. Its incidence and prevalence in developing countries is steadily rising and has been attributed to the rapid modernization and Westernization of the population. There is a need to reconcile the most appropriate treatment for these patient populations from the perspectives of both disease presentation and cost. In the West, biological agents are the fastest-growing segment of the prescription drug market. These agents cost thousands of dollars per patient per year. The healthcare systems, and certainly the patients, in developing countries will struggle to afford such expensive treatments. The need for biological therapy will inevitably increase dramatically, and the pharmaceutical industry, healthcare providers, patient advocate groups, governments and non-governmental organizations should come to a consensus on how to handle this problem. The evidence that IBD is now affecting a much younger population presents an additional concern. Meta-analyses conducted in patients acquiring IBD at a young age also reveals a trend for their increased risk of developing colorectal cancer (CRC), since the cumulative incidence rates of CRC in IBD-patients diagnosed in childhood are higher than those observed in adults. In addition, IBD-associated CRC has a worse prognosis than sporadic CRC, even when the stage at diagnosis is taken into account. This is consistent with additional evidence that IBD negatively impacts CRC survival. A continuing increase in IBD incidence worldwide associated with childhood-onset of IBD coupled with the diseases’ longevity and an increase in oncologic transformation suggest a rising disease burden, morbidity, and healthcare costs. IBD and its associated neoplastic transformation appear inevitable, which may significantly impact pediatric gastroenterology and adult CRC care. Due to an infrastructure gap in terms of access to care between developed vs. developing nations and the uneven representation of IBD across socioeconomic strata, a plan is needed in the developing world regarding how to address this emerging problem.

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Section: Resultsmentioning

confidence: 99%

Inflammatory Bowel Disease: An Expanding Global Health Problem

M’Koma

2013

Clin Med Insights Gastroenterol

261

225

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“…1), indicator of the oedema associated with the inflammatory process. It is important to point out that Amanda ® extract at 25, 50 and 100 mg/kg displayed the same effect than sulphasalazine, a classic drug for the treatment of human IBD (Benchimol et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

Intestinal anti-inflammatory activity of the polyphenolic-enriched extract Amanda® in the trinitrobenzenesulphonic acid model of rat colitis

Zorrilla

Rodríguez-Nogales

Algieri

et al. 2014

Journal of Functional Foods

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“…Thus, in a recent study of patients with CD aged over 65 years, in 2007 about 30% in the USA were on a thiopurine, as compared with about 15% in Canada and Denmark, and only about 10% in the UK [10]. In the same report, anti-TNF agents were used in 15% patients >65 years in USA, 6% of patients in Canada and 3% of patients in Denmark in 2009.…”

Section: Are Too Few CD Patients Given Maintenance Treatment?mentioning

confidence: 98%

Are Maintenance Strategies Underused in Crohn's Disease?

Rampton

2014

Dig Dis

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A key aim in the management of Crohn's disease is to maintain disease remission, whether this has been achieved by medical or surgical treatment. The reasons for doing this are to maintain quality of life, to avoid steroid dependence and to maintain mucosal healing with a view to preventing relapse, hospital admission and surgery, and improving disease natural history. Options for remission maintenance include smoking cessation, thiopurines, methotrexate, anti-TNF-α drugs and surgery. Evidence suggests that in some places now, and in most places in the past, too few patients are/were appropriately treated when in remission, and, in many instances, treatment regimens are/were insufficiently tailored to the patient's individual phenotype, prognosis and/or genotype.

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International variation in medication prescription rates among elderly patients with inflammatory bowel disease

Abstract: Significant variation in medication prescription rates exists among countries. Future research should assess whether these differences were associated with disparities in outcomes and health care costs.

Cited by 64 publications

References 29 publications

Inflammatory Bowel Disease: An Expanding Global Health Problem

Inflammatory Bowel Disease: An Expanding Global Health Problem

Intestinal anti-inflammatory activity of the polyphenolic-enriched extract Amanda® in the trinitrobenzenesulphonic acid model of rat colitis

Are Maintenance Strategies Underused in Crohn's Disease?

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