A national survey on the patterns of treatment of inflammatory bowel disease in Canada
A national survey on the patterns of treatment of inflammatory bowel disease in Canada
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DOI：
10.1186/1471-230x-3-10
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发表时间：
2003-06-05
影响因子：
2.4
通讯作者：
Pocobelli, G
中科院分区：
文献类型：
--
作者：
Hilsden, RJ;Verhoef, MJ;Pocobelli, G
背景资料：在广泛的、地理上多样化的非诊所人群中，普遍缺乏关于炎症性肠病（IBD）护理的信息。本研究的目的是（1）比较从国家克罗恩病和结肠炎基金会成员中抽取的样本与已发表的基于临床和基于人群的IBD样本，（2）描述当前的医疗保健使用模式，（3）确定IBD治疗方式和治疗人员是否存在意外变化。方法：对加拿大克罗恩病和结肠炎基金会的4453名成员进行了邮寄调查。调查问卷，在成员声明的语言偏好，包括项目的人口统计学和疾病特征，一般健康行为和当前和过去的IBD治疗。每个成员收到一个初始的和一个提醒mailing.Results：回条返回的1787，913，和128人克罗恩病，溃疡性结肠炎和不确定性结肠炎，分别。1159例克罗恩病患者至少进行了一次手术，风险随着疾病的持续时间而增加。溃疡性结肠炎患者手术率的区域差异被确定。24%的克罗恩病患者和12%的溃疡性结肠炎患者使用6-巯基嘌呤/硫唑嘌呤（差异的5% CI：8.9% - 15%）。在克罗恩病患者中，使用与性别，收入或居住地区无关，但与年龄和疾病活动标志物相关。112名受访者（4%）使用英夫利昔单抗，其中大多数患有克罗恩病。英夫利西单抗的使用没有因居住地区和收入而发生变化。68%的受访者表示，他们最依赖胃肠病学家的IBD护理。在这方面有很大的区域差异。然而，满意度与初级医生并不取决于医生类型（例如，胃肠病与全科医生）。结论：本研究实现了获得一个大的，地理上不同的样本，更具有代表性的一般IBD人群比诊所样本的目标。我们没有发现任何证据表明，由于性别、居住地区或收入水平，医疗服务存在显著的区域差异。注意到不同年龄组之间的差异，这值得进一步关注。
Background: There is a general lack of information on the care of inflammatory bowel disease (IBD) in a broad, geographically diverse, non-clinic population. The purposes of this study were (1) to compare a sample drawn from the membership of a national Crohn's and Colitis Foundation to published clinic-based and population-based IBD samples, (2) to describe current patterns of health care use, and (3) to determine if unexpected variations exist in how and by whom IBD is treated.Methods: Mailed survey of 4453 members of the Crohn's and Colitis Foundation of Canada. The questionnaire, in members stated language of preference, included items on demographic and disease characteristics, general health behaviors and current and past IBD treatment. Each member received an initial and one reminder mailing.Results: Questionnaires were returned by 1787, 913, and 128 people with Crohn's disease, ulcerative colitis and indeterminate colitis, respectively. At least one operation had been performed on 1159 Crohn's disease patients, with risk increasing with duration of disease. Regional variation in surgical rates in ulcerative colitis patients was identified. 6-Mercaptopurine/Azathioprine was used by 24% of patients with Crohn's disease and 12% of patients with ulcerative colitis ( 5% CI for the difference: 8.9% - 15%). In patients with Crohn's disease, use was not associated with gender, income or region of residence but was associated with age and markers of disease activity. Infliximab was used by 112 respondents (4%), the majority of whom had Crohn's disease. Variations in infliximab use based on region of residence and income were not seen. Sixty-eight percent of respondents indicated that they depended most on a gastroenterologist for their IBD care. There was significant regional variation in this. However, satisfaction with primary physician did not depend on physician type (for example, gastroenterologist versus general practitioner).Conclusion: This study achieved the goal of obtaining a large, geographically diverse sample that is more representative of the general IBD population than a clinic sample would have been. We could find no evidence of significant regional variation in medical treatments due to gender, region of residence or income level. Differences were noted between different age groups, which deserves further attention.