Quality Indicators for Inflammatory Bowel Disease

Melmed, Gil Y.; Siegel, Corey A.; Spiegel, Brennan M.; Allen, John I.; Cima, Robert R.; Colombel, Jean Fréd́eric; Dassopoulos, Themistocles; Denson, Lee A.; Dudley-Brown, Sharon; Garb, Andrew; Hanauer, Stephen B.; Kappelman, Michael D.; Lewis, James D.; Lynch, Isabelle; Moynihan, Amy; Rubin, David T.; Sartor, R. Balfour; Schwartz, Ronald M.; Wolf, Douglas C.; Ullman, Thomas

doi:10.1097/mib.0b013e31828278a2

Cited by 121 publications

(54 citation statements)

References 29 publications

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“…[1,15] The CCFA and the European Crohn’s and Colitis Organisation (ECCO) have called for more extensive quality metrics, e.g., Human papilloma virus vaccination. [16,17]We chose the AGA metrics which align with ACR quality metrics.…”

Section: Introductionmentioning

confidence: 99%

Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home

Caldera

Saha

Wald

et al. 2016

Expert Review of Gastroenterology & Hepatology

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Background Rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) patient populations face similar risks of chronic immunosuppression including corticosteroid use. We compared the receipt of preventive services between IBD and RA populations according to published quality metrics. Methods We defined a single-center cohort of patients with IBD or RA receiving specialty and primary care. Electronic health record abstraction assessed quality metrics, sociodemographics, comorbidity, and utilization. Comparisons used multivariate odds ratios and Student’s t-tests. Results 218 RA and 190 IBD patients were included. In multivariate analysis, IBD patients were less likely to receive pneumococcal vaccination (OR=0.29, 95% CI: 0.11–0.85), while RA patients underwent glucocorticoid-induced osteoporosis screening more often (100% vs. 82.5%, p = 0.023). Conclusions Gastroenterologists can improve care quality for IBD patients by assuming greater responsibility for preventive care in IBD patients and/or collaborating with primary care and health systems to improve preventive care delivery.

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Section: Introductionmentioning

confidence: 99%

Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home

Caldera

Saha

Wald

et al. 2016

Expert Review of Gastroenterology & Hepatology

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“…The baseline questionnaire, completed on paper during patients’ office visits and subsequently uploaded to a REDCap electronic database, included questions from the sCDAI and the Mayo score as well as a variety of quality of life questions derived from work by the Crohn’s and Colitis Foundation of America’s Quality of Care task force (Supplemental Figure 1). 13 The latter were used as distractors to limit priming of the sCDAI and Mayo score questions for the follow-up questionnaire. Participants were asked to report their symptoms from the prior day, and were then randomized to receive the follow-up questionnaire via email on one of the subsequent seven days.…”

Section: Methodsmentioning

confidence: 99%

Measurement of Inflammatory Bowel Disease Symptoms

Henao¹,

Bewtra

Osterman³

et al. 2015

Inflammatory Bowel Diseases

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Background The Crohn’s Disease Activity Index (CDAI) and Mayo score for ulcerative colitis (UC) require symptom recall and/or use of a symptom diary. We examined patients’ abilities to recall their symptoms and the day-to-day variability of symptoms. Methods Patients with UC or CD completed a questionnaire including items from the short CDAI (sCDAI) and the 6-point Mayo score. Patients were randomized to receive a follow-up questionnaire testing recall of the bowel symptom items between 1 to 7 days later. In a second study, patients completed a 7-day electronic diary recording their symptoms. sCDAI and 6-point Mayo scores were computed. Analyses estimated daily variability in the indices and misclassification rates when using fewer than 7 days of data. Results 100%, 82%, and 90% of CD participants recalled the same disease activity status (i.e. active vs. remission) as reported on the initial survey when the follow-up questionnaire was administered 1–2, 3–5, and 6–8 days later, respectively. Compared to using 7 days of data, when using only day 7 data 3.7% of CD patients were misclassified as active or inactive. Disease activity was misclassified in 2.8%, 4.9%, and 3.3% of patients by using the last 2, 3, or 4 days, respectively. Results were similar for UC patients. Conclusions Patients with CD and UC demonstrated good recall of bowel symptoms for up to 8 days. Additionally, bowel symptoms have relatively little variability within a 7-day period allowing for accurate computation of the sCDAI and 6-point Mayo score using 1–3 days of data.

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“…The American Gastroenterology Association has recommended 10 indices as a measurement of quality of care in IBD [30] (Table 2). Similarly, the Crohn's and Colitis Foundation of America have also proposed a questionnaire for the assessment of quality of care of patients with IBD [31,32] (Table 2). In order to identify a set of quality indices, Calvet et al [33] conducted a two-round web-based survey including an expert panel of patient representatives (n = 4), nurses (n = 7), surgeons (n = 2) and physicians (n = 18) using Delphi consensus-based approach.…”

Section: Quality Indicators For Ibdmentioning

confidence: 99%

Quality of care in Crohn's disease

Makharia

2014

WJGP

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Crohn's disease (CD) is a chronic and progressive inflammatory disease of the intestine. Overall, healthcare delivery for patients with CD is not optimal at the present time and therefore needs improvement. There are evidences which suggest that there is a variation in the care provided to patients with CD by the inflammatory bowel disease (IBD) experts and community care providers. The delivery of healthcare for patients with CD is often complex and requires coordination between gastroenterologists/IBD specialist, gastrointestinal surgeon, radiologists and IBD nurses. In order to improve the quality of health care for patients with CD, there is need that we focus on large-scale, system-wide changes including creation of IBD comprehensive care units, provision to provide continuous care, efforts to standardize care, and education of the community practitioners.

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Quality Indicators for Inflammatory Bowel Disease

Cited by 121 publications

References 29 publications

Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home

Comparing guideline-based care quality for inflammatory bowel disease and rheumatoid arthritis patients within a medical home

Measurement of Inflammatory Bowel Disease Symptoms

Quality of care in Crohn's disease

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