Psychometric evaluation of a patient-reported outcome measure in pancreatic exocrine insufficiency (PEI)

Johnson, C. D.; Williamson, Nicola; Solingen, Gwendolyn Janssen-van; Arbuckle, Rob; Johnson, Chloe; Simpson, S. P.; Staab, Doris; Domínguez‐Muñoz, Enrique; Lévy, P; Connett, Gary; Lerch, Markus M.

doi:10.1016/j.pan.2018.11.013

Cited by 40 publications

(27 citation statements)

References 13 publications

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“…Improving and facilitating data collection in itself, however, would allow for increased performance in screening for, and management of, CP complications. Developing standardized clinical instruments for patient screening and evaluation in clinical practice, such as patient questionnaires, could possibly improve assessment of patient symptomatology as well as serve as outcome indicators for evaluation of clinical practice, ultimately improving patient care [ 19 ]. Standardized PEI-specific evaluation tools have been suggested to improve identification, management and diagnosis of PEI, as well as assist in management of already diagnosed PEI [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Adherence to European Guidelines for Treatment and Management of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis Patients

Khan

Rutkowski

Vujasinović

et al. 2021

JCM

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European evidence-based guidelines for the treatment and management of chronic pancreatitis (CP) have been made available following the harmonizing diagnosis and treatment of CP across Europe (HaPanEU) initiative by the United European Gastroenterology (UEG). The aim of this study was to evaluate adherence to the guideline recommendations in the management of patients with pancreatic exocrine insufficiency (PEI) at Karolinska University Hospital in Stockholm. UEG guideline recommendations were evaluated and categorized into 55 different quality indicators (QIs). Data from a retrospective cohort of CP patients being treated at Karolinska University Hospital were evaluated with regard to overall adherence as well as adherence to specific QIs. A total number of 118 patients out of 956 patients diagnosed with CP were eligible for inclusion with mean overall adherence of 61.9% to the defined QIs. A significant difference in mean overall adherence was shown between patients diagnosed with CP prior to 1 January 2016 and following 1 January 2016 (59.3% and 67.7% respectively, p = 0.004), with linear regression analysis also demonstrating improvement correlating to date of diagnosis (p = 0.002). In conclusion, diagnosis and treatment of PEI improved after the HaPanEU guidelines became available and is continuously improving; however, there is room for further improvement.

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Section: Discussionmentioning

confidence: 99%

Adherence to European Guidelines for Treatment and Management of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis Patients

Khan

Rutkowski

Vujasinović

et al. 2021

JCM

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“…Besides pancreatic exocrine insufficiency, small intestinal bacterial overgrowth, pain-induced anorexia and ongoing alcohol and nicotine consumption present presumed risk factors. 27,28 An elevated resting energy expenditure, found in 30%-50% of patients, may further contribute to loss of muscle mass and function. 29 For malnutrition and sarcopenia alike, the use of inconsistent definitions and diagnostic modalities makes accurate prevalence estimation difficult.…”

Section: Introductionmentioning

confidence: 99%

“…Malnutrition and sarcopenia are frequent complications of CP. Besides pancreatic exocrine insufficiency, small intestinal bacterial overgrowth, pain‐induced anorexia and ongoing alcohol and nicotine consumption present presumed risk factors 27,28 . An elevated resting energy expenditure, found in 30%‐50% of patients, may further contribute to loss of muscle mass and function 29 .…”

Section: Introductionmentioning

confidence: 99%

Preclinical insights into the gut‐skeletal muscle axis in chronic gastrointestinal diseases

Ehlers

Bannert

Rohde

et al. 2020

J Cellular Molecular Medi

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Muscle wasting represents a constant pathological feature of common chronic gastrointestinal diseases, including liver cirrhosis (LC), inflammatory bowel diseases (IBD), chronic pancreatitis (CP) and pancreatic cancer (PC), and is associated with increased morbidity and mortality. Recent clinical and experimental studies point to the existence of a gut‐skeletal muscle axis that is constituted by specific gut‐derived mediators which activate pro‐ and anti‐sarcopenic signalling pathways in skeletal muscle cells. A pathophysiological link between both organs is also provided by low‐grade systemic inflammation. Animal models of LC, IBD, CP and PC represent an important resource for mechanistic and preclinical studies on disease‐associated muscle wasting. They are also required to test and validate specific anti‐sarcopenic therapies prior to clinical application. In this article, we review frequently used rodent models of muscle wasting in the context of chronic gastrointestinal diseases, survey their specific advantages and limitations and discuss possibilities for further research activities in the field. We conclude that animal models of LC‐, IBD‐ and PC‐associated sarcopenia are an essential supplement to clinical studies because they may provide additional mechanistic insights and help to identify molecular targets for therapeutic interventions in humans.

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“…Malnutrition is a frequent complication of CP caused by pancreatic exocrine insufficiency, 16 small intestinal bacterial overgrowth, 17 pain‐induced anorexia, or ongoing alcohol and nicotine consumption. In ~30–50% of patients, elevated resting energy expenditure may further impair nutritional status 18 .…”

Section: Introductionmentioning

confidence: 99%

Nutritional management of chronic pancreatitis: A systematic review and meta‐analysis of randomized controlled trials

Wiese

Gärtner

Doller

et al. 2020

J of Gastro and Hepatol

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Background and Aim Malnutrition is a frequent complication of chronic pancreatitis. Adequate nutritional support is imperative, but there is still uncertainty about the optimal nutritional treatment. This work systematically compiles evidence from randomized controlled trials investigating dietary interventions in chronic pancreatitis and, in a further step, contrasts those findings with existing dietary recommendations. Methods The literature search (PubMed and Cochrane Central Register of Controlled Trials) included English and German full‐text articles, which had been published in peer‐reviewed journals. Two independent reviewers identified and selected studies. For meta‐analysis, forest plots with 95% confidence intervals were generated using a random‐effects model. Results Eleven randomized controlled trials fulfilled all selection criteria. In these trials, the following dietary interventions were tested: antioxidant treatment (n = 6), vitamin D supplementation (n = 3), supplementation with oral nutritional supplements (n = 1), and symbiotics supplementation (n = 1). Studies were of good methodological quality (mean Jadad score of 3.6) but heterogeneous in terms of interventions and study populations. Only for vitamin D, there was convincing evidence for efficacy of supplementation. We found no effect for antioxidant treatment on pain relief (standardized mean difference = −0.12; 95% confidence interval −0.73 to 0.48) and limited generalizability for interventions with oral nutritional supplements and symbiotics. Conclusions Nutritional management in chronic pancreatitis remains challenging. As well‐designed randomized controlled trials are scarce, in large part, recommendations can only be based on low‐level evidence studies or expert opinion. For now, consumption of a balanced diet remains the cornerstone recommendation for prevention, whereas more goal‐directed interventions are indicated for specific nutrient deficiencies.

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Psychometric evaluation of a patient-reported outcome measure in pancreatic exocrine insufficiency (PEI)

Cited by 40 publications

References 13 publications

Adherence to European Guidelines for Treatment and Management of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis Patients

Adherence to European Guidelines for Treatment and Management of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis Patients

Preclinical insights into the gut‐skeletal muscle axis in chronic gastrointestinal diseases

Nutritional management of chronic pancreatitis: A systematic review and meta‐analysis of randomized controlled trials

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