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在炎症性肠病中评估疾病控制:英国的真实世界横截面研究 (PODCAST-IBD)
Shanika de Silva1, Helen Steed2, Patrick B Allen3
1Department of Gastroenterology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
大约一半的炎症性肠病 (IBD) 患者的疾病控制能力不足,主要是由于生活质量受损 (QOL). 这显著影响了疲劳,残疾,医疗费用和工作生产力.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 临床研究 临床研究
- 现实世界 证据研究 实证研究
背景情况:
- 炎症性肠病 (IBD) 的管理旨在实现最佳的疾病控制.
- 在现实环境中评估疾病控制对于有效的治疗策略至关重要.
研究的目的:
- 量化IBD患者中低于最佳疾病控制的比例.
- 评估非最佳疾病控制对患者结果和医疗保健资源利用的影响.
- 通过使用STRIDE-II建议,确定IBD控制不足的关键贡献者.
主要方法:
- 一项涉及英国四个中心198名IBD患者的横截面研究.
- 通过临床医生报告的结果,患者报告的结果和医疗病历审查收集的数据.
- 对STRIDE-II红旗进行评估的IBD控制,包括使用短炎性肠病问卷 (SIBDQ) 评估的生活质量 (QOL).
主要成果:
- 52.4%的克罗恩病 (CD) 和45.3%的性结肠炎 (UC) 患者表现出不理想的IBD控制.
- 在64%的病例中,QOL受损 (SIBDQ得分<50) 是对次优控制的主要贡献者.
- 低于最佳控制导致QOL显著降低,疲劳增加 (FACIT-F得分较低),医疗资源使用率更高 (HCRU),工作生产率损失更大.
结论:
- 大约一半的IBD患者经历了低于最佳的疾病控制,这在很大程度上是由受损的QOL驱动的.
- 低于最佳的IBD控制对患者的福祉产生了重大负面影响和重大经济后果.
- 建议定期进行质量生活评估,以早期发现活跃疾病并及时调整治疗.
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