Nav: Home

'Specialty medical home' seeks to provide patient-centered care for patients with inflammatory bowel diseases

May 04, 2016

May 4, 2016 - A specialty medical home--providing expert medical care coordinated with attention to social support and mental health--is a promising new approach to patient-centered, cost-effective care for patients with Crohn's disease and ulcerative colitis, according to a special "Future Directions" paper in the May issue of Inflammatory Bowel Diseases, official journal of the Crohn's & Colitis Foundation of America (CCFA). The journal is published by Wolters Kluwer.

The inflammatory bowel diseases specialty medical home (IBD SMH) is "a new model of care that places the patient at the center of the medical universe," write Dr. Miguel D. Regueiro and colleagues of University of Pittsburgh Medical Center and UPMC Health Plan. They share their institution's experience with developing a specialty medical home to provide comprehensive care for IBD.

Specialty Medical Home Approach for Coordinated Care of IBD

The "patient-centered medical home" has emerged as a new model to improve coordination of healthcare services while controlling costs. So far, most studies of this approach have focused on primary care settings, with mixed results in terms of patient outcomes and healthcare spending.

But for patients with IBD, most care is provided by gastroenterologists and other specialists. "Clinicians who care for these patients recognize that this population requires specialized and personalized care," Dr. Regueiro and coauthors write.

Created in collaboration between healthcare providers and payers, the IBD SMH focuses on providing "high-quality, comprehensive, cost-effective, patient-centered care" for Crohn's disease and ulcerative colitis. While this approach can potentially improve care for all patients, it focuses on the relatively small group who incur disproportionately high costs. Specialists at UPMC found that 14 percent of patients accounted for nearly half of spending for IBD care.

The IBD SMH seeks to address the high rates of emotional difficulties, pain, and poor social support experienced by these "high utilizers." Dr. Regueiro and colleagues explain that pain, stress, coping problems, anxiety, depression, and fatigue can all affect the disease process in IBD--contributing to worsened inflammation and increased healthcare needs.

In addition to optimizing medical and surgical care, the specialty medical home approach aims to enhance behavioral skills, improve social support, and reduce stress. Care is provided by a team including gastroenterologists and personal nurse coordinators, as well as surgeons, behavioral health and pain specialists, dietitians, and other professionals.

Key aspects of the specialty medical home approach include an IBD Patient Checklist to ensure that all recommended preventive care steps are followed; individualized psychological care, addressing the "brain-gut" connection by which stress, anxiety, and depression can lead to worsening of IBD; optimal approaches to pain management, including evidence-based nondrug approaches; and nutritional support to address the special dietary needs of people with IBD.

Dr. Regueiro and colleagues believe the SMH IBD can provide "patient-centered care that improves the value and quality of the medical experience while reducing cost." They hope their experience will be helpful to other medical centers interested in developing specialty medical homes, for IBD or other chronic diseases requiring specialist care.

But the authors emphasize that many challenges remain in optimizing the care provided by the IBD SMH and demonstrating its benefits in terms of improved patient care and reduced costs. Dr. Regueiro and colleagues conclude, "The future of healthcare will rely on chronic care models that have yet to be realized, and the gastroenterologist will play a central role in the IBD management paradigm of tomorrow."

Crohn's disease is a painful, medically incurable illness that may cause inflammation anywhere along the digestive system. Crohn's disease and ulcerative colitis, which involves only the large intestine (colon), are the two main types of inflammatory bowel diseases. Some 1.6 million American adults and children suffer from Crohn's disease or ulcerative colitis.
Click here to read "The Inflammatory Bowel Disease Specialty Medical Home: A New Model of Patient-centered Care."

Article: "The Inflammatory Bowel Disease Specialty Medical Home: A New Model of Patient-centered Care" (doi: 10.1097/MIB.0000000000000819)

Note to editors: For further information, contact Erin Stoeber, Vice President of Marketing & Communications for the CCFA: phone 347-899-5479 or e-mail">

About Inflammatory Bowel Diseases

Inflammatory Bowel Diseases brings the most current information in clinical and basic sciences to physicians caring for patients with inflammatory bowel diseases, and investigators performing research in IBD and related fields. Each issue contains cutting-edge original basic science and clinical articles on diagnosis, treatment, and management of IBD from clinicians and researchers around the world. Coverage includes articles highlighting the unique and important issues in pediatric IBD, as well as articles pertaining to adult patients.

About CCFA

The Crohn's & Colitis Foundation of America (CCFA) is the largest voluntary non-profit health organization dedicated to finding cures for Inflammatory Bowel Diseases (IBD). CCFA's mission is to cure Crohn's disease and ulcerative colitis, and to improve the quality of life of children and adults who suffer from 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, call 888-694-8872, like us on Facebook, or follow us on Twitter.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

For more information about our products and organization, visit, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

Wolters Kluwer Health

Related Ulcerative Colitis Articles:

Fecal microbiota transplant is safe and effective for patients with ulcerative colitis
A single transplant of microbes contained in the stool of a healthy donor is a safe and effective way to increase diversity of good bacteria in the guts of patients with ulcerative colitis, according to new research from Weill Cornell Medicine and NewYork-Presbyterian.
Yoga helps patients with ulcerative colitis
Patients with ulcerative colitis, a chronic inflammatory bowel disease, often relapse at times of stress.
Crohn's & Colitis Foundation and AGA announce conference partnership
The Crohn's & Colitis Foundation and the American Gastroenterological Association announced today that they are partnering to co-sponsor the first-ever 'Crohn's & Colitis Congress,' which will take place in Las Vegas in January 2018.
Low level vitamin D during remission contributes to relapse in ulcerative colitis patients
A new study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) has found that lower levels of vitamin D in the blood increase the risk of clinical relapse in patients with Ulcerative Colitis (UC), an inflammatory bowel disease that causes long-lasting inflammation and ulcers in the colon.
U-M researchers discover what makes drug for ulcerative colitis tick
For approximately 70 years, physicians have used a medication containing the active agent mesalamine to treat ulcerative colitis, but little was known about how the drug targeted the inflammatory bowel disease.
Protozoan parasite increases risk of colitis, study reveals
Researchers from the University of Toronto have discovered that mice infected with the common gut parasite Tritrichomonas muris are at an increased risk of developing inflammatory colitis.
Iron-deficiency anemia in ulcerative colitis -- many patients don't get testing and treatment
Many patients with ulcerative colitis don't receive recommended testing and treatment for the common problem of iron deficiency anemia, reports a study in the October issue of Inflammatory Bowel Diseases, official journal of the Crohn's & Colitis Foundation of America (CCFA).
Transplanting healthy stool might be an answer to ulcerative colitis
Fecal microbiota transplantation -- a treatment currently used to address recurring Clostridium difficile infection -- is also an effective approach to helping individuals who suffer from ulcerative colitis, according to a study being presented at Digestive Disease Week®.
Study advances understanding of colon cancer and colitis
The transcription factor hepatocyte nuclear factor 4-alpha (HNF4-alpha) plays a key role in colon cancer and colitis.
Study shows ozanimod as effective in treating ulcerative colitis
Researchers at University of California San Diego School of Medicine have shown that ozanimod (RPC1063), a novel drug molecule, is moderately effective in the treatment of ulcerative colitis.

Related Ulcerative Colitis Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Failure can feel lonely and final. But can we learn from failure, even reframe it, to feel more like a temporary setback? This hour, TED speakers on changing a crushing defeat into a stepping stone. Guests include entrepreneur Leticia Gasca, psychology professor Alison Ledgerwood, astronomer Phil Plait, former professional athlete Charly Haversat, and UPS training manager Jon Bowers.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".