炎症性腸疾患における多専門的予防ケアの最適化:紹介パターン、アドヒアランス、寛解
Sarah A Bokaee1, Anushka Deogaonkar1, Maxwell S Madani1
1Division of Gastroenterology and Liver Disease, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA.
Cureus
|January 28, 2026
まとめ
炎症性腸疾患(IBD)患者における積極的な皮膚科紹介は、患者のアドヒアランスと寛解を改善する。これらの紹介の標準化、特に眼科については、より良い結果を得るための多分野にわたるケアを強化する。
科学分野:
- 消化器病学
- 皮膚病学
- 眼科学
背景:
- 炎症性腸疾患(IBD)では、皮膚や眼に影響を与える腸管外合併症(EIMs)が一般的である。
- 現在のガイドラインでは多専門的な監視が推奨されているが、紹介の実践は一貫していない。
- 一貫性のない紹介は、IBDの疾患コントロールや患者のアウトカムに影響を与える可能性がある。
研究 の 目的:
- IBD患者の皮膚科および眼科への紹介パターンを分析する。
- 紹介アドヒアランスと疾患寛解との関連を評価する。
- 皮膚科と眼科の紹介理由とアドヒアランス率を比較する。
主な方法:
- 都市部の学術医療センターにおける成人IBD患者の後ろ向きカルテレビュー。
- 活動性の皮膚科または眼科紹介のある患者を含めた。
- 紹介パターン、予約アドヒアランス、寛解状態を分析した。
主要な成果:
- 両科への紹介アドヒアランスは、IBD寛解と有意に関連していた(p < 0.05)。
- 皮膚科紹介はアドヒアランスが高く、予防的な場合が多かった。
- 眼科紹介は、症状駆動型および合併症関連の場合が多かった。
結論:
- IBD患者における予防的な皮膚科サーベイランスは、より良いアドヒアランスとアウトカムと相関している。
- 皮膚科紹介のための積極的なモデルは、IBD管理を改善する可能性がある。
- 多専門的なIBDケアを強化するためには、特に眼科のための標準化された紹介フレームワークが必要である。
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