Inflammatory bowel disease: epidemiology and management in an English general practice population
Inflammatory bowel disease: epidemiology and management in an English general practice population
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DOI：
10.1046/j.1365-2036.2000.00886.x
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发表时间：
2000-12-01
影响因子：
7.6
通讯作者：
Ling, J
中科院分区：
文献类型：
--
作者：
Rubin, GP;Hungin, APS;Ling, J
背景：炎症性肠病具有显著的长期发病率和医疗资源后果。基于二级护理记录的研究可能低估了全科医生(GP)对其管理的贡献。目的：以全科医生记录为主要数据来源，描述炎症性肠病的流行病学和管理。方法：系统地搜索英格兰北部的全科医生临床记录，确定炎症性肠病的病例、患者会诊行为、处方模式和专科护理的程度。结果：在135 723名人口中，溃疡性结肠炎的发病率为每年13.9/10万(CI：7.5-20.3)，克罗恩病的发病率为8.3/10万(CI：3.4-13.2)。1995年1月1日溃疡性结肠炎的年龄性别调整点患病率为243.4/10万(CI：217.4~269.4)，克罗恩病的年龄-性别调整点患病率为144.8/10万(CI：124.8~168.8)。平均会诊次数(S.D.)在转诊后的头12个月(专家3.94+/-3.15，普通科医生3.34+/-3.55)和最近12个月(1.02+/-2.02，1.04+/-2.04)，与专科医生和全科医生的情况相似。只有29.9%的患者明确接受专科护理。结论：炎症性肠病的患病率，但不是发病率，比以前在英国人口中的描述要高得多。全科医生为满足这些患者的医疗保健需求做出了重大贡献。
Background: Inflammatory bowel diseases have significant long-term morbidity and healthcare resource consequences. Studies based on secondary care records may have underestimated the contribution of general practitioners (GPs) to its management.Aims: To describe the epidemiology and management of inflammatory bowel disease using GP records as the primary data source.Methods: A systematic search of GP clinical records in northern England, identifying cases of inflammatory bowel disease, patient consultation behaviour, prescribing patterns, and extent of specialist care.Results: In a population of 135 723, the incidence of ulcerative colitis was 13.9/100 000 per year (CI: 7.5-20.3) and for Crohn's disease 8.3/100 000 per year (CI: 3.4-13.2). The age-sex adjusted point prevalence for ulcerative colitis on 1st January 1995 was 243.4/100 000 (CI: 217.4-269.4) and for Crohn's disease 144.8/100 000 (CI: 124.8-168.8). The mean number of consultations (s.d.) with specialists and GPs were similar, both in the first 12 months after referral (specialists 3.94 +/- 3.15, GPs 3.34 +/- 3.55) and in the most recent 12 months (1.02 +/- 2.02, 1.04 +/- 2.04). Only 29.9% of all patients were definitely under specialist care.Conclusions: Prevalence rates, but not incidence rates, for inflammatory bowel disease are substantially higher than previously described in UK populations. General practitioners make a significant contribution to meeting the healthcare needs of these patients.