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International Journal of Colorectal Disease

Erschienen in:

07.12.2018 | Original Article

Guideline recommendations for treatment of patients with inflammatory bowel diseases are not implemented in clinical practice—results of a non-representative survey

verfasst von: Lea I. Kredel, Oliver Schneidereit, Jörg C. Hoffmann, Britta Siegmund, Jan C. Preiß

Erschienen in: International Journal of Colorectal Disease | Ausgabe 3/2019

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Abstract

Purpose

There is a growing evidence for over-, under-, or misuse of health care in patients with inflammatory bowel disease. Most studies looked at treatment variability or used quality measures, which mostly capture supportive interventions rather than treatment of IBD in itself. We aimed to evaluate if current recommendations in clinical practice guidelines regarding the medical treatment of patients with inflammatory bowel diseases are being followed in Germany.

Methods

A questionnaire was sent to 1901 patients insured with two large German statutory sickness funds and an ICD 10 diagnosis of Crohn’s disease (CD) or ulcerative colitis (UC). The questionnaire asked about drug treatment, indications for drug treatment, provision of surveillance endoscopies in ulcerative colitis patients, and smoking status in Crohn’s disease patients.

Results

Out of 460 evaluable patients, 62.4% of UC patients and 53.9% of CD patients were treated with mesalamine according to guidelines, 91.3% of all patients were treated with glucocorticoids according to guideline recommendations, while only 75.6% received recommended immunosuppressive treatment. Of UC patients, 94.5% had surveillance colonoscopies at the recommended interval and 58.8% of CD patients were non-smokers. No predictor for overall treatment according to guidelines could be found while being of age older than 60 or being treated outside of a dedicated IBD clinic was associated with less immunosuppressive treatment.

Conclusions

A large proportion of patients with IBD do not receive drug treatment in accordance with clinical practice guidelines. Quality improvement measures are much needed.

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Titel: Guideline recommendations for treatment of patients with inflammatory bowel diseases are not implemented in clinical practice—results of a non-representative survey
verfasst von: Lea I. Kredel
Oliver Schneidereit
Jörg C. Hoffmann
Britta Siegmund
Jan C. Preiß
Publikationsdatum: 07.12.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Colorectal Disease / Ausgabe 3/2019
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3215-3

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Guideline recommendations for treatment of patients with inflammatory bowel diseases are not implemented in clinical practice—results of a non-representative survey