PhD Scientific Days 2019

Poster presentations: Immunology

Harmonisation of quality of care in an IBD centre impacts disease outcomes: importance of structure and process indicators

Előadó neve

Dr. Gönczi, Lóránt

Előadó munkahelye

Semmelweis University, 1st Department of Internal Medicine

Előadó telefonszáma

+36308208250

Előadó e-mail címe

lorantgonczi@gmail.com

Az előadás címe

Harmonisation of quality of care in an IBD centre impacts disease outcomes: importance of structure and process indicators

Szerző(k) neve és munkahelye

L Gonczi1; Z Kurti*1; J Reinglas2; S Restellini2; S Nene2; R Kohen2; W Afif2; T Bessissow2; G Wild2; E Seidman2; A Bitton2; P Lakatos1,2


*presenting author

1. Semmelweis University, First Department of Medicine, Budapest, Hungary
2. Mcgill University Health Center, Department of Gastroenterology, Montreal, Canada

Bemutatás módja

Poszter

Szekció

Poster presentations: Immunology

Language of the presentation

English

Témacsoport

other

Összefoglaló szövege

Background
Optimal management of IBD requires harmonised monitoring and treatment pathways.

Aim
We aimed to evaluate the quality of care at the McGill University Health Center (MUHC) IBD Center using quality of care indicators (QIs) including patient assessment strategy, monitoring, treatment decisions, and outcomes.

Methods
We retrospectively analysed the quality of care IBD patients were receiving before and after their referral to MUHC IBD specialist and establishing the MUHC IBD centre. Consecutive patients were included with an outpatient visit (‘index visit’) at the MUHC IBD Centre from July 2016 to December 2016.

Results
In total, 1357 patients were included. At referral, a large proportion of patients were objectively re-evaluated (ileocolonoscopy:79%, cross-sectional imaging:15.6% of CD patients had abdomino-pelvic MRI or CT and 23.6% abdominal US, biomarkers CBC, CRP and FCAL: 89.9%, 81.9% and 16.5%, respectively). Therapeutic strategy was changed in 53.6% with 22.5% of patients starting biologics. Tight objective patient monitoring was applied also during follow-up (colonoscopy: 79%, cross-sectional imaging: 61.8% within 2 years prior to the index visit). Additional colonoscopy and imaging to evaluate disease activity was ordered in 32% and 19% within 6 months after the index visit. The frequency of therapeutic drug monitoring (TDM) was escalated following the establishment of the IBD centre. Maximum therapeutic step was accelerated with 48.8% of patients on biological therapy at the time of index visit. The need for surgery (4.3%) and hospitalisation (7.6%) were relatively low, while 16.8% of patients needed an IBD-related ER visit within 6 months after index visit.

Conclusion
Our data support that tight monitoring was applied at the MUHC IBD centre with a high emphasis on objective patient (re)evaluation, timely access and accelerated treatment strategy at referral or during follow-up. QIs mapped in this study can serve as reference data for comparison on structure, process algorithms and outcomes for IBD centres worldwide.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1103

Presentation file URL

//docs.kmcongress.com/phd2019/eposter_5931.png

Authors (legacy)

L Gonczi1; Z Kurti*1; J Reinglas2; S Restellini2; S Nene2; R Kohen2; W Afif2; T Bessissow2; G Wild2; E Seidman2; A Bitton2; P Lakatos1,2


*presenting author

1. Semmelweis University, First Department of Medicine, Budapest, Hungary
2. Mcgill University Health Center, Department of Gastroenterology, Montreal, Canada

Data of the presenter

Doctoral School: Clinical Medicine
Program: 2/15 Molecular Genetics, Pathomechanism and Clinical Aspects of Metabolic Disorders
Supervisor: Peter L. Lakatos
E-mail address: lorantgonczi@gmail.com
poster presentation