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Beyond drugs for IBD: Improving the overall health of IBD patients

January 19, 2018

Las Vegas, NV (Jan. 19, 2017) -- 1.6 million Americans suffer from inflammatory bowel disease (IBD) -- a chronic, life-long disease which includes Crohn's disease and ulcerative colitis. Identifying the best medical treatment leads to improved disease management, but IBD patients also experience mental, emotional and other physical side effects that need to be understood and managed to improve the overall health of IBD patients.

Research presented at the Crohn's & Colitis Congress™ helps health care providers understand how to better manage their patients' overall health and mental well-being to increase the quality of their lives.

The following five studies being presented at the inaugural Crohn's & Colitis Congress -- a partnership of the Crohn's & Colitis Foundation and the American Gastroenterological Association, in Las Vegas, NV, on Jan. 19 and 20 -- provide important guidance for physicians to enhance IBD patient care.

High Opioid Use Among IBD Patients with Chronic Abdominal Pain

Study Title: What is the Rate of Chronic Opioid Use and How It Impacts Healthcare Utilization Within an IBD Clinic Population

By Bill Hacker, University of Kentucky, et al.

Significance: With the alarming rise of opioid use in the U.S., it is important for health care providers to understand prescription rates and patient use patterns to help solve the crisis. Researchers at the IBD clinic at the University of Kentucky sought to quantify opioid use for the management of chronic abdominal pain and the impact it has on health care. They found alarmingly high chronic opioid use among IBD patients at their clinic -- of the 740 patients seen in the IBD clinic over the study period, 23.8 percent were prescribed opioids at least once and 10.1 percent fulfilled the definition of chronic opioid use. Patients on chronic opioids were more likely to obtain analgesics from several different providers and pharmacies and be diagnosed with psychiatric disease. Patients with chronic opioid use also had more than double the number of emergency room visits and CT/MRI scans compared to non-chronic users. For patients experiencing chronic abdominal pain, gastroenterologists should consider alternative options for analgesia and involving addiction and pain specialists.

Disclosures: the authors have no financial relationships to disclose.

For the full abstract, email media@gastro.org.

Better Management of Anemia Will Improve Overall Outcomes

Study Title: Reduction in the Prevalence of Anemia Among Patients with Inflammatory Bowel Disease After Implementation of the Anemia Care Pathway

By Jason K. Hou, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, et al.

Significance: Anemia in IBD patients leads to reduced quality of life and increased resource use, but it is an under-recognized complication with low screening and management. Researchers at Baylor University measured the clinical implementation of the Crohn's and Colitis Foundation Anemia Care Pathway, which was developed to provide a practical approach to anemia management in IBD patients. After analyzing 1,428 patient encounters from 908 unique patients, researchers determined that use of the Anemia Care Pathway increased the proportion of anemic patients on iron therapy and decreased the prevalence of anemia. As anemia was still present in a quarter of patient encounters, researchers recommend use of population management tools to help improve implementation of the anemia care pathway.

Disclosures: lead author Jason K. Hou reports financial relationships with Abbvie, Janssen, Pfizer, Celgene, Redhill Biopharm and Eli Lilly. For co-author disclosures and the full abstract, email media@gastro.org.

IBD Patients Need Better Understanding of CRC Screening Intervals

Study Title: Patient Experiences with Colorectal Cancer Surveillance in Inflammatory Bowel Disease: A Qualitative Study

By Jason K. Hou, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, et al.

Significance: Patients with IBD are at increased risk of developing colorectal cancer (CRC), and benefit from a surveillance colonoscopy screening program. However, not all patients understand that they undergo regular colonoscopies for CRC prevention or detection, and not IBD disease management. Researchers performed a qualitative study with 30 IBD patients and identified factors that have a negative impact on acceptance of surveillance, including discrepancy in colonoscopy interval recommendations between providers, patient awareness of lack of uniform guidelines, and communication with other IBD patients with differing colonoscopy intervals. Researchers used their findings to develop a model of IBD patient decision-making for CRC surveillance, which they hope will be used to inform development of a patient-centered intervention for IBD-related CRC surveillance and prevention.

Disclosures: lead author Jason K. Hou reports financial relationships with Abbvie, Janssen, Pfizer, Celgene, Redhill Biopharm and Eli Lilly. The co-authors have no financial relationships to disclose.

For the full abstract, email media@gastro.org.

Informed and Active IBD Patients Have Improved Outcomes

Study Title: High Patient Activation is Associated with Clinical Remission in a Longitudinal Analysis of a Large Internet Based Cohort of Patients with Inflammatory Bowel Disease

By Edward L. Barnes, University of North Carolina at Chapel Hill School of Medicine, et al.

Significance: Patients who are more knowledgeable about their disease and have the skills and confidence to effectively manage their care, known as patient activation, have been shown to have improved outcomes for many chronic conditions. Researchers administered the Patient Activation Measure (@Insignia Health) to 1,486 patients from the Crohn's & Colitis Foundation internet cohort to evaluate the association between patient activation and IBD patient disease remission. For the 73 percent of patients for whom follow-up data is available, researchers demonstrated that patient activation is strongly associated with clinical remission. Efforts to improve patient activation through tailored interventions for IBD patients have the potential to improve outcomes.

Disclosures: Dr. Barnes has no financial relationships to disclosure. For co-author disclosures and the full abstract, email media@gastro.org.

Increased Communication Between GIs and Primary Care Can Improve Vaccination Management

Study Title: Vaccinations in IBD Patients: Gastroenterologists' vs. Internists/Practice and Perceptions of Responsibility

By Muhammad B. Hammami, Saint Louis University, et al.

Significance: While IBD patients are at increased risk of vaccination-preventable infections, it is often unclear whether their gastroenterologist or primary care provider should manage their vaccinations. According to this study, there are important differences in perceptions about who should manage IBD patients' vaccinations. Gastroenterologists were more likely to believe that they should manage their patients' vaccination status and more often provided hepatitis A and B vaccines, as well as vaccinated patients before immune suppression. However, they were less likely than primary care physicians to provide pertussis, zoster and diphtheria vaccines. Vaccination guidelines and improved communication between gastroenterologists and primary care physicians are needed for effective and efficient management of IBD patients.

Disclosures: Dr. Hammami has no financial relationships to disclosure. For co-author disclosures and the full abstract, email media@gastro.org.

All abstracts accepted to the Crohn's & Colitis Congress will be published in Inflammatory Bowel Diseases® (the official journal of the Crohn's & Colitis Foundation) and Gastroenterology (the official journal of the American Gastroenterological Association) on Jan. 19.

Attribution to the Crohn's & Colitis Congress™ is requested in all coverage.
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About the Crohn's & Colitis Congress™

The Crohn's & Colitis Congress™, taking place Jan. 18-20, 2018 in Las Vegas, combines the strengths of the nation's leading IBD patient organization, Crohn's & Colitis Foundation (formerly CCFA), and the premier GI professional association, American Gastroenterological Association (AGA). Together we are committed to convening the greatest minds in IBD to transform patient care. The Crohn's & Colitis Congress is the must-attend meeting for all IBD professionals. Learn more at http://crohnscolitiscongress.org.

About the Crohn's & Colitis Foundation

The Crohn's & Colitis Foundation is the largest non-profit, voluntary, health organization dedicated to finding cures for inflammatory bowel diseases (IBD). The Foundation's mission is to cure Crohn's disease and ulcerative colitis, and to improve the quality of life of children and adults who are affected by these diseases. The Foundation works to fulfill its mission by funding research; providing educational resources for patients and their families, medical professionals, and the public; and furnishing supportive services for those afflicted with IBD. For more information visit http://www.crohnscolitisfoundation.org, call 888-694-8872, or email info@crohnscolitisfoundation.org.

About the AGA Institute

The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. http://www.gastro.org.

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