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Preventive Care Gets Short Shrift in Inflammatory Bowel Disease

LAS VEGAS -- Patients with inflammatory bowel disease (IBD) often miss discussing preventive services with their clinicians, according to a study presented here.

Discussions regarding vaccines happened with 45.3% of these patients based on chart review at a single center, reported Amanda Lynn, MD, of Mayo Clinic in Rochester, Minnesota, at the Crohn's & Colitis Congress.

The most common was discussion of the pneumonia vaccine (42%), flu shot (33.3%), and hepatitis vaccine (37.3%) whereas only 14.3% talked with their provider about human papilloma virus vaccines and 19.3% about the tetanus, diphtheria, and pertussis (Tdap) vaccine.

Among other preventive services, bone health and smoking cessation were the most commonly discussed (55.4% and 46.2%), while discussions about cervical cancer only reached 15.5% of participants. Skin cancer was discussed with 29.9%.

"Over a third of patients indicated symptoms of possible depression or anxiety on their intake forms, while only 10% of them had documented discussions regarding these symptoms," Lynn said.

Clinicians have access to a number of health maintenance checklists for adult IBD patients in an effort to prevent mental health disorders, malignancy, infection, and metabolic bone disease. Although these clinical checklists and guidelines are available, findings suggest that IBD patients are less likely to receive preventive care services when compared to the general population, Lynn noted.

"The frequency at which preventive services were discussed in this patient cohort was less than ideal," Lynn said.

Lynn cited the following strategies to enhance delivery of preventive services:

  • Developing electronic health record resources to remind patients and/or providers of appropriate services
  • Incorporating additional members of the medical team, like medical assistants
  • Designating a preventive health champion
  • Using brief screening resources to pinpoint mental health concerns

Other strategies include having patients fill out pre-visit surveys to collect information for reminders and discussion aids and having protocols in place to clearly communicate recommendations with the primary provider when the provider is not administering services.

Lynn's group evaluated 150 patients, among whom 74% were male and the mean age was 42. Participants underwent chart review as researchers gathered information on IBD type, current medical treatments, demographic information, and preventive care services.

Among the patients, 44.7% had ulcerative colitis, 48.7% had Crohn's disease, and 6.7% had indeterminate colitis. Of the participants, 43.3% used steroids, 20.7% used immunomodulator treatment, and 42.7% used biologic treatment.

Lynn acknowledged the study's limitations in that the investigation was done at a tertiary referral center, patients had to travel a long distance, and patients often had a single consultation without any longitudinal follow-up.

Lynn did not report any disclosures.

Source: https://www.medpagetoday.com/meetingcoverage/ccc/77964

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