Medication, hospitalization and surgery all contribute to improving the health of patients with inflammatory bowel disease, but results of a longitudinal study revealed that the sickest patients maintain a higher risk for IBD-related disability.
Leigh Anne Shafer, PhD, of the IBD Clinical and Research Centre at the Rady College of Medicine at the University of Manitoba in Canada, said in a video perspective that she and her colleagues explored how indicators of health care use reflect moderate to severe disease related to disability later in life.
“We may reasonably assume that IBD-related disability is worse among those requiring elevated health care,” she said. “We can also reasonably assume, or hope, that is the goal, that the health care provided — the surgeries, hospitalization, the medications — improves the health and quality of life of recipients of the health care.”
For the study, 854 patients in the population-based University of Manitoba IBD Research Registry completed a survey, which included the IBD Disability Index (IBDDI), and gave researchers permission to access their health records. Investigators explored the association between health care use indicators, like surgery, hospitalization and new corticosteroid or anti-TNF prescriptions, and high IBD-related disability (IBDDI 35).
Shafer and colleagues found that 85% of patients required at least one IBD-related surgery since diagnosis, had more than two hospitalizations or were ever prescribed corticosteroids or anti-TNF.
When looking at medication prescriptions, researchers found that high disability was more prevalent among patients who were ever prescribed anti-TNF (49%) compared with those never prescribed (28%; P < .001). It was also more prevalent among patients ever prescribed corticosteroids (35%) compared with those never prescribed (26%; P = .02).
Surgery was also an indicator of disability among patients with either one (36%) or more than one IBD-related surgery (53%) compared with patients who had none (28%; P < .001).
Shafer said that patients who undergo these treatments might see improvements to their health but not to the same level as patients who never needed them in the first place.
“In the absence of a direct measure, past health care utilization can be used as a proxy for current IBD-related disability,” she said. “Persons requiring those indicators should be followed more closely for social, mental and physical consequences of IBD-related disability.” – by Alex Young
Disclosures: Shafer reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.