Signifikante Änderungen der Pharmakotherapie in der gastroenterologischen Rehabilitation von Patienten mit Morbus Crohn

Reichel, Christoph; Streit, Jürgen; Wunsch, Steffen

doi:10.1055/s-0029-1241811

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…This analysis was performed as part of a larger, ongoing project to characterize gastroenterological rehabilitation, the results of which have been presented elsewhere [6,7]. In short, a single-center chart review was performed in a 228-bed inpatient rehabilitation center where patients with gastrointestinal diseases from all regions of Germany are rehabilitated.…”

Section: Methodsmentioning

confidence: 99%

Appropriateness of Crohn’s Disease Therapy in Gastroenterological Rehabilitation

Reichel¹,

Streit²,

Ott³

et al. 2010

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Background/Aims: The treatment criteria developed by the European Panel on the Appropriateness of Crohn’s Disease (CD) Therapy (EPACT) have not been applied to rehabilitation. Thus, we retrospectively evaluated appropriateness of treatments during CD rehabilitation using the EPACT website. Methods: We included our 1-year inpatient rehabilitation patients that had been assigned the International Classification of Disease Code for CD. The appropriateness of treatment was assessed in CD categories exhibiting frequent treatment changes. Treatment plans were compared to EPACT recommendations. Results: Charts of 337 proven CD patients (median age 42 [range 17–65] years, 250 women, median Crohn’s Disease Activity Index 140 [range –3 to 427] units) were assigned to EPACT categories. The categories ‘steroid-dependent’ and ‘steroid-refractory’ exhibited frequent treatment changes. In these 59 patients, 16 treatments (13 azathioprine, 1 methotrexate, 2 infliximab) were rated as appropriate. One certolizumab treatment was uncertain. 22 treatments with azathioprine were inappropriate (21 due to underdosing), and 93 treatments (30 mesalamine, 59 steroid, 4 budesonide) were not rated. The number of differences between treatment plans and EPACT recommendations decreased from 45 to 25 in both CD categories (p < 0.0001). Conclusions: We introduce the EPACT website as a practical advance towards an optimal therapy in rehabilitants with steroid-dependent or -refractory CD.

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Section: Methodsmentioning

confidence: 99%