Impact of an integrated model of care on outcomes of patients with inflammatory Bowel diseases: Evidence from a population-based study

Juan Nicolás Peña-Sánchez, Lisa M. Lix, Gary F. Teare, Wenbin Li, Sharyle A. Fowler, Jennifer L. Jones

Résultat de recherche: Articleexamen par les pairs

28 Citations (Scopus)

Résumé

Background and Aims: Studies evaluating the impact of integrated models of care [IMC] for inflammatory bowel disease [IBD] on disease-related outcomes are needed. We compared the risk of IBD-related outcomes and prescription medication claims between patients exposed and nonexposed to an IMC. Methods: A retrospective population-based matched cohort study was conducted between 2009 and 2015, using administrative health data of Saskatchewan, Canada. Patients aged 18+ years with a diagnosis of IBD were identified with a validated administrative definition. Cases were classified as exposed and non-exposed to the IMC for IBD and matched based on propensity scores and disease duration. IBD-related hospitalisations, surgeries, prescription medication claims, and corticosteroid dependency [CsDep] were measured. Cox and logistic regression models evaluated differences between the groups, estimating hazard [HRs] and odds [ORs] ratios with corresponding confidence intervals [CIs]. Results: In total, 2312 matched patients were included; 24.3% were exposed individuals. Compared with non-exposed, exposed patients had a lower risk of IBD-related surgeries [HR = 0.78, 95% CI 0.61-0.99], higher risk of prescriptions of immune modulators [HR = 1.68, 95% CI 1.42-1.99], and biologics [HR = 1.85, 95% CI 1.52-2.27], and a lower risk of 5-aminosalicylic acid prescriptions [HR = 0.81, 95% CI 0.69-0.95]. A lower risk of IBD-related hospitalisations among exposed ulcerative colitis [UC] patients [HR = 0.66, 95% CI 0.49-0.89] was identified in stratified analyses. The odds of CsDep among exposed UC patients was 0.39 [95% CI 0.15-0.98]. Conclusions: The observed differences in disease-related outcomes and use of steroid-sparing maintenance therapies between exposed and non-exposed individuals support the concept that enhanced quality of care can be achieved within IMC for IBD.

Langue d'origineEnglish
Pages (de-à)1471-1479
Nombre de pages9
JournalJournal of Crohn's and Colitis
Volume11
Numéro de publication12
DOI
Statut de publicationPublished - déc. 4 2017

Note bibliographique

Publisher Copyright:
© 2017 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press.

ASJC Scopus Subject Areas

  • Gastroenterology

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article

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