P-109 YI Predictors of Health-Related Quality of Life and Adherence in Crohnʼs Disease and Ulcerative Colitis

Abstract

BACKGROUND: Radiation exposure from medical imaging can cause appreciable long-terms risks for patients. Approximately 2% of all future cancers may be attributable to CT imaging. Patients with certain conditions, including inflammatory bowel disease (IBD), are likely to receive more CT imaging than others. Abdominal CT scans expose patients to a radiation dose of 10 millisieverts. Although guidelines have not been established, the recommended maximum annual radiation dose for the general public is 1 millisievert. This study examined abdominal CT ordering by medical specialties caring for IBD patients who received excess radiation exposure, defined as ≥3 CT scans over a 3.5 year period. METHODS: A retrospective medical record review of inflammatory bowel disease patients managed at an urban university during a 3.5 year period was performed using a multispecialty electronic health record. All patients age ≥18 were included. There were no exclusion factors. Patient age, gender, disease type, number of abdominal CTs scans, and the specialty of the ordering physician for each scan were obtained. A database, maintaining patient confidentiality, was created. Statistical analysis was performed using repeated-measures ANOVA with significance set at P < 0.05. The study was approved by the university institutional review board. RESULTS: Three hundred sixteen medical records (189 women, 127 men, with a mean age of 41.8 years) were reviewed. One hundred seventy-one patients had Crohn's disease, 143 with ulcerative colitis, and 2 with indeterminate colitis. Twenty-two (7.6%) of these patients had ≥3 CTs during the study period. A total of 125 CTs were performed on the 22 patients, for a mean of 5.7 CTs per patient. Of the CTs, 56 (44.4%) were ordered by general internists, averaging 2.5 CTs per patient; 30 CTs (23.8%) were ordered by emergency medicine physicians, averaging 1.4 CTs per patient; 20 CTs (15.9%) were ordered by surgeons, averaging 0.9 CTs per patient; 12 CTs (9.5%) were ordered by gastroenterologists, averaging 0.5 CTs per patient, 8 CTs (6.3%) ordered by physicians of other specialties, averaging 0.4 CTs per patient. There was a significant difference in the rate at which physicians of different specialties ordered abdominal CT scans on inflammatory bowel disease patients (P ¼ 0.002). Nineteen of 22 patients (86.7%) had CTs ordered by multiple departments. Patients receiving ≥3 CTs had a CT ordered from an average of 2.6 physicians of different specialties (SD 1.2). CONCLUSIONS: Patient with IBD are likely to receive imaging studies, such as abdominal CTs, during the course of their illness. There has been speculation that some inflammatory bowel disease patients receive excess radiation exposure from frequent CT scans. This study revealed that approximately 7% of IBD patients received ≥3 abdominal CT scans, with an average of 5.7 CTs, within 3.5 years.Internists and emergency medicine physicians ordered the largest proportion of abdominal CT scans. Gastroenterologists ordered <10% of these studies, suggesting t...

Further Validation of the Crohn’s and Ulcerative Colitis Questionnaire-32 (CUCQ-32) to Measure the Quality of Life in Patients Treated with Biologics Therapy

“…Inflammatory Bowel Disease (IBD) is known to impair quality of life (QoL) [ 1 , 2 , 3 ] and cause a substantial burden to patients, their families and society [ 4 , 5 , 6 ]. Alternating relapsing and remitting episodes characterise the chronic, incurable nature of the condition with a wide variation in symptom severity and complexity.…”