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Quality of Care in Inflammatory Bowel Disease

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Abstract

Advances in the treatment of inflammatory bowel disease (IBD) are published routinely in medical journals. Some treatments are sufficiently helpful that their conclusions are incorporated into clinical guidelines. However, such publications and proclamations may go unheeded among practitioners. Underuse, overuse, and misuse of clinical therapeutics, diagnostics, and routine medical processes are sufficiently prevalent among IBD practitioners that movements are afoot to determine the best methods for achieving a minimal uniformity of effective care. Such explorations are part of an effort to improve the quality of care. In this article, we review the background that has led to a push toward quality improvements in medicine in general, in gastroenterology in general, and within IBD specifically.

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References

Papers of particular interest, published recently, have been highlighted as:•Of importance

  1. Institute of Medicine: Medicare: A Strategy for Quality Assurance. Edited by Lohr KN. Washington, DC: National Academy Press; 1990.

    Google Scholar 

  2. Deming WE: A system of profound knowledge. In The New Economics for Industry, Government, Education, edn 2. Cambridge, MA: MIT Press; 2000.

  3. Donabedian A: Evaluating quality of medical care. In Program Evaluation in the Health Fields. Edited by Schulberg HC, Sheldon A, Baker F. New York: Behavioral Publications; 1969.

    Google Scholar 

  4. Larson JS, Muller A: Managing the quality of health care. J Health Hum Serv Adm 2002, 25:261–80.

    PubMed  Google Scholar 

  5. • Kappelman MD, Palmer L, Boyle BM, Rubin DT: Quality of care in inflammatory bowel disease: a review and discussion. Inflamm Bowel Dis 2010, 16:125–133. This paper highlights the approaches to quality improvement, especially the structure/process/outcome framework, and shows how IBD can be approached in that manner. It highlights current trends in health policy that will impact quality of care.

  6. Committee on Quality of Health Care in America, Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academy Press; 2001.

    Google Scholar 

  7. Sipkoff M: Can transparency save health care? Managed Care 2004;3.

  8. • Christianson JB, Volmar KM, Alexander J, Scanlon DP: A report card on provider report cards: current status of the health care transparency movement. J Gen Intern Med 2010, 25:1235–1241. This paper describes the current availability of physician data for care. It examines the content, consumer usefulness, and geographic variability in transparency. It is one of the few papers on this topic to date.

  9. Fung CH, Lim YW, Mattke S, et al.: Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med 2008, 148:111–123.

    PubMed  Google Scholar 

  10. Harris KM, Buntin MB: Choosing a Health Care Provider: The Role of Quality Information. The Synthesis Project: Research Synthesis Report Number 14. Princeton, NJ: The Robert Wood Johnson Foundation; 2008.

    Google Scholar 

  11. Wagner EH, Austin BT, Davis C, et al.: Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 2001, 20:64–78.

    Article  CAS  Google Scholar 

  12. Bodenheimer T, Wagner EH, Grumbach K: Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA 2002, 288:1909–1914.

    Article  PubMed  Google Scholar 

  13. Gawande A: The bell curve. The New Yorker 2004:82–91.

  14. National Committee for Quality Assurance: Gastroesophageal reflux disease (GERD): Physician Performance Measurement Set; 2005. Available at http://www.qualitymeasures.ahrq.gov/content.aspx?id=10293. Accessed October 2010.

  15. • National Committee for Quality Assurance: Endoscopy and Polyp Surveillance. Agency for Healthcare Research and Quality; 2008. Available at http://www.qualitymeasures.ahrq.gov/content.aspx?id=13551. Accessed October 2010. Document outlining the various quality measures adopted for endoscopy. Both this and reference 14 are examples of the way to calculate each of the quality measures. This document also is well referenced for each measure, some of which apply to IBD.

  16. Rabeneck L, Rumble R, Axler J, et al.: Cancer care Ontario colonoscopy standards: standards and evidentiary base. Can J Gastroenterol 2007:SD:5D–24D.

    Google Scholar 

  17. Loftus EV Jr: Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology 2004, 126:1504–1517.

    Article  PubMed  Google Scholar 

  18. Loftus EV Jr, Silverstein MD, Sandborn WJ, et al.: Crohn’s disease in Olmsted County, Minnesota, 1940–1993: incidence, prevalence, and survival. Gastroenterology 1998, 114:1161–1168.

    Article  PubMed  Google Scholar 

  19. Loftus EV, Jr., Silverstein MD, Sandborn WJ, et al.: Ulcerative colitis in Olmsted County, Minnesota, 1940–1993: incidence, prevalence, and survival. Gut 2000, 46:336–343.

    Article  PubMed  Google Scholar 

  20. McLeod RS, Churchill DN, Lock AM, et al.: Quality of life of patients with ulcerative colitis preoperatively and postoperatively. Gastroenterology 1991, 101:1307–1313.

    CAS  PubMed  Google Scholar 

  21. Cohen RD: The quality of life in patients with Crohn’s disease. Aliment Pharmacol Ther 2002, 16:1603–1609.

    Article  CAS  PubMed  Google Scholar 

  22. Kappelman MD, Rifas-Shiman SL, Porter CQ, et al.: Direct health care costs of Crohn’s disease and ulcerative colitis in US children and adults. Gastroenterology 2008, 135:1907–1913.

    Article  PubMed  Google Scholar 

  23. Esrailian E, Spiegel BM, Targownik LE, et al.: Differences in the management of Crohn’s disease among experts and community providers, based on a national survey of sample case vignettes. Aliment Pharmacol Ther 2007, 26:1005–1018.

    Article  CAS  PubMed  Google Scholar 

  24. Kappelman MD, Bousvaros A, Hyams J, et al.: Intercenter variation in initial management of children with Crohn’s disease. Inflamm Bowel Dis 2007, 13:890–895.

    Article  PubMed  Google Scholar 

  25. Reddy SI, Friedman S, Telford JJ, et al.: Are patients with inflammatory bowel disease receiving optimal care? Am J Gastroenterol 2005, 100:1357–1361.

    Article  PubMed  Google Scholar 

  26. O’Connor GT, Plume SK, Olmstead EM, et al.: A regional intervention to improve the hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group. JAMA 1996, 275:841–846.

    Article  PubMed  Google Scholar 

  27. Schechter MS, Margolis P: Improving subspecialty healthcare: lessons from cystic fibrosis. J Pediatr 2005, 147:295–301.

    Article  PubMed  Google Scholar 

  28. Jones R, Hunt C, Stevens R, et al.: Management of common gastrointestinal disorders: quality criteria based on patients’ views and practice guidelines. Br J Gen Pract 2009, 59:e199–e208.

    Article  PubMed  Google Scholar 

  29. Wennberg JE: Unwarranted variations in healthcare delivery: implications for academic medical centres. BMJ 2002, 325:961–964.

    Article  PubMed  Google Scholar 

  30. Colletti RB, Baldassano RN, Milov DE, et al.: Variation in care in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2009, 49:297–303.

    Article  CAS  PubMed  Google Scholar 

  31. Kornbluth A, Sachar DB: Ulcerative colitis practice guidelines in adults (update): American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 2004, 99:1371–1385.

    Article  PubMed  Google Scholar 

  32. Eaden JA, Ward BA, Mayberry JF: How gastroenterologists screen for colonic cancer in ulcerative colitis: an analysis of performance. Gastrointest Endosc 2000, 51:123–128.

    Article  CAS  PubMed  Google Scholar 

  33. Bernstein CN, Leslie WD, Leboff MS: AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology 2003, 124:795–841.

    Article  PubMed  Google Scholar 

  34. Kornbluth A, Hayes M, Feldman S, et al.: Do guidelines matter? Implementation of the ACG and AGA osteoporosis screening guidelines in inflammatory bowel disease (IBD) patients who meet the guidelines’ criteria. Am J Gastroenterol 2006, 101:1546–1550.

    Article  PubMed  Google Scholar 

  35. Kane S, Reddy D: Guidelines do help change behavior in the management of osteoporosis by gastroenterologists. Am J Gastroenterol 2006, 101:1841–1844.

    Article  PubMed  Google Scholar 

  36. Wagnon JH, Leiman DA, Ayers GD, et al.: Survey of gastroenterologists’ awareness and implementation of AGA guidelines on osteoporosis in inflammatory bowel disease patients: are the guidelines being used and what are the barriers to their use? Inflamm Bowel Dis 2009, 15:1082–1089.

    Article  PubMed  Google Scholar 

  37. Melmed GY, Ippoliti AF, Papadakis KA, et al.: Patients with inflammatory bowel disease are at risk for vaccine-preventable illnesses. Am J Gastroenterol 2006, 101:1834–1840.

    Article  PubMed  Google Scholar 

  38. Trindade AJ, Ehrlich A, Kornbluth A, Ullman TA: Are your patients taking their medicine? Validation of a new adherence scale in patients with inflammatory bowel disease and comparison with physician perception of adherence. Inflamm Bowel Dis 2010 (Epub ahead of print).

  39. Fuller-Thomson E, Sulman J: Depression and inflammatory bowel disease: findings from two nationally representative Canadian surveys. Inflamm Bowel Dis 2006, 12:697–707.

    Article  PubMed  Google Scholar 

  40. Tremaine WJ, Sandborn WJ, Loftus EV, et al.: A prospective cohort study of practice guidelines in inflammatory bowel disease. Am J Gastroenterol 2001, 96:2401–2406.

    Article  CAS  PubMed  Google Scholar 

  41. Crandall W, Kappelman M, Colletti RB, et al.: Increased Remission in a Quality Improvement Collaborative for Pediatric Crohn Disease. J Pediatr Gastroenterol Nutr 2009, 49:E60.

    Article  Google Scholar 

  42. Khanna D, Arnold EL, Pencharz JN, et al.: Measuring process of arthritis care: the Arthritis Foundation’s quality indicator set for rheumatoid arthritis. Semin Arthritis Rheum 2006, 35:211–237.

    Article  PubMed  Google Scholar 

  43. Kanwal F, Kramer J, Asch SM, et al.: An explicit quality indicator set for measurement of quality of care in patients with cirrhosis. Clin Gastroenterol Hepatol 2010, 8:709–717.

    Article  PubMed  Google Scholar 

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Acknowledgment

Dr. Ullman’s work was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases grant K-08- DK069393.

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No potential conflict of interest relevant to this article was reported.

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Authors and Affiliations

  1. Center for Inflammatory Bowel Disease, The Dr. Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA

    Brijen Shah, Andrew Tinsley & Thomas Ullman

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  1. Brijen Shah
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  2. Andrew Tinsley
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  3. Thomas Ullman
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Correspondence to Thomas Ullman.

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Shah, B., Tinsley, A. & Ullman, T. Quality of Care in Inflammatory Bowel Disease. Curr Gastroenterol Rep 13, 87–94 (2011). https://doi.org/10.1007/s11894-010-0155-7

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