scholarly journals The Effect of a Tailored Patient Activation Intervention in Inflammatory Bowel Disease Patients

2019 ◽  
Vol 66 (3) ◽  
pp. 11-21 ◽  
Author(s):  
Chisom Kanu ◽  
Carolyn Brown ◽  
Jamie Barner ◽  
Casey Chapman ◽  
Heather Walker
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Patient Activation ◽  
Baseline Survey ◽  
Control Group ◽  
Post Intervention ◽  
Inflammatory Bowel ◽  
And Control ◽  
The Impact

Purpose A pre-test, post-test, control group design was employed to investigate the impact of a tailored patient activation intervention (PAI) among inflammatory bowel disease (IBD) patients. Methods Patients who met the inclusion criteria were selected from medical records via convenience sampling, were consented, and completed a baseline survey. Based on responses to the baseline 13-item patient activation measure (PAM-13), they were categorized into one of four patient activation stages. During office visits, intervention patients (N=23) were given a tailored PAI based on their baseline stage, which consisted of an information booklet and focused discussion with the gastroenterologist, while the control group (N=27) received usual care. Baseline and 1-month post-intervention scores were compared between the intervention (N=20) and control (N=21) groups for changes in patient activation score, medication adherence, and satisfaction with care. Results Most participants were Caucasian (88%), female (64%), college graduates (56%), and had Crohn's disease (59.2%). Overall, females had a significantly higher (p=0.04) mean activation score (mean=70.9±15.4) than males (mean=60.9±10.7) at baseline. This trend was the same post-intervention (75.6 females vs 64.4 males; p=0.03). The difference in mean activation scores pre- vs post-intervention was not statistically significant between the intervention and control groups (mean=4.9±12.3, p=0.21). However, this difference could be considered to be clinically significant based on results from previous studies. There were no significant differences in medication adherence or satisfaction scores pre- vs post-intervention for either group. Conclusion Tailored PAIs have the potential to increase activation level of patients with inflammatory bowel disease. This customized medical interaction increased patient involvement in disease management and could potentially lead to improved health outcomes.

scholarly journals DEDICATED PSYCHIATRY CLINIC FOR INFLAMMATORY BOWEL DISEASE PATIENTS HAS A POSITIVE IMPACT ON DEPRESSION SCORES

2021 ◽  
Author(s):  
Kaleb Bogale ◽  
Sanjay Yadav ◽  
August Stuart ◽  
Allen R. Kunselman ◽  
Shannon Dalessio ◽  
...  
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Depression Score ◽  
Control Group ◽  
Study Cohort ◽  
Psychiatry Clinic ◽  
Tertiary Center ◽  
Inflammatory Bowel ◽  
The Impact

BACKGROUND: Psychiatric disorders, including anxiety and depression, are significantly more common in patients with inflammatory bowel disease. We established an integrated psychiatry clinic for IBD patients at our tertiary center IBD clinic to provide patients with critical, but frequently unavailable, coordinated mental health services. We undertook this study to evaluate the impact of this service on psychiatric outcomes, quality of life, and symptom experience. METHODS: We performed a longitudinal prospective study comparing patients who had been cared for at our integrated IBD-psychiatry clinic to those who had not. We abstracted demographic and clinical information as well as contemporaneous responses to validated surveys. RESULTS: Thirty-six patients cared for in the IBD-psychiatry clinic were compared to a control cohort of thirty-five IBD patients. There was a significant reduction in the HADS depression score over time in the study cohort (p=0.001), though not in the HADS anxiety score. When compared to the control group, the study cohort showed a significant reduction in the HADS depression score. No significant differences were observed in the HBI, SCCAI or SIBDQ. CONCLUSIONS: This is the first study to evaluate the impact of an integrated psychiatry clinic for IBD patients. Unlike their control counterparts, individuals treated in this clinic had a significant reduction in mean HADS depression score. Larger scale studies are necessary to verify these findings. However, this study suggests that use of an integrated psychiatry-IBD clinic model can result in improvement in mental health outcomes, even in the absence of significant changes in IBD activity.

P026 The impact of different dietary factors in the etiopathogenesis of inflammatory bowel disease: a retrospective case–control study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
C M Preda ◽  
T Manuc ◽  
A E Chifulescu ◽  
D Istratescu ◽  
E Louis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Protective Factor ◽  
Ice Cream ◽  
Dietary Factors ◽  
Control Group ◽  
High Fat ◽  
Fried Food ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Inflammatory bowel disease development has been associated with several environmental factors, among which diet can play a key role, probably due to a westernised lifestyle. However, its involvement in the pathogenesis of IBD is difficult to be demonstrated. The aim of this study was to analyse dietary composition in a Romanian and Belgian population with IBD. Methods We conducted an observational retrospective comparative study using two European cohorts (Romanian and Belgian). The IBD group included 76 Romanian and 53 Belgian patients with an IBD diagnosis while the control group included 56 healthy persons (35 Romanians and 21 Belgians). All subjects were interviewed and asked to fill in a questionnaire regarding diet. Results The baseline characteristics of the patients included in the two cohorts were described in the table. Figures 1 and 2 illustrated the consumption of different foods in Romanian, respectively, Belgian IBD patients before the onset of the disease vs. healthy controls (variables were compared with Fisher’s exact test). In the entire IBD cohort (Romanian+Belgian), we found a significantly increased consumption of sweets (OR 3.36[95% CI 1.6,7]), processed and high-fat meat (OR 2.5[95% CI1.4, 4.7], fried food (OR 9.5[3.8, 23.6]), salt (OR 2.8[1.5, 5.3]), ice cream (OR 3.25[1.1, 9.8]), mayonnaise (OR 3.49[1.1, 10.3]), margarine (OR 5.63[1.64, 19.33]), chips/nachos/other snacks (OR 2.3[0.97, 5.73]), compared with the healthy control group. The intake of seeds, nuts (OR 0.26[0.14,0.52]) and the yoghurt consumption (OR 0.44[0.23, 0.83]) was lower in the IBD group compared with the control group. Conclusion In Romanian and Belgian IBD patients, a westernised diet with increased consumption of sweets, processed food, high-fat meat, fried food, salt, margarine, snacks, ice cream and mayonnaise seems to be a risk factor for IBD. Food intake of seeds, nuts and yogurt may be a protective factor.

scholarly journals Impact of BMGIM Music Therapy on Emotional State in Patients with Inflammatory Bowel Disease: A Randomized Controlled Trial

2021 ◽  
Vol 10 (8) ◽  
pp. 1591
Author(s):  
Vicente Alejandro March-Luján ◽  
Vicente Prado-Gascó ◽  
José María Huguet ◽  
Xavier Cortés ◽  
José María Paredes Arquiola ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Emotional State ◽  
Control Group ◽  
Acute And Chronic Stress ◽  
State Of Mind ◽  
Inflammatory Bowel ◽  
The Impact

Background. Patients with inflammatory bowel disease (IBD) have a high prevalence of emotional disturbances which worsen the symptoms of the disease. As a therapeutic alternative that is part of a comprehensive care alongside medication, the Bonny Method of Guided Imagery and Music (BMGIM) music-assisted therapy has achieved promising emotional improvements in patients with chronic diseases. The objective of the study was to determine the impact of a treatment based on a BMGIM group adaptation on patients with inflammatory bowel disease (IBD) and their emotional state, therefore analyzing state of mind, quality of life, anxiety, depression, immunocompetence as a marker of well-being, and levels of acute and chronic stress. Methods. Longitudinal, prospective, quantitative, and experimental study including 43 patients with IBD divided into an intervention group (22 patients), who received eight sessions over eight weeks, and a control group (21 patients). A saliva sample was taken from each patient before and after each session in order to determine cortisol and IgA levels. Similarly, a hair sample was taken before the first and after the last session to determine the cumulative cortisol level. All molecules were quantified using the ELISA immunoassay technique. In addition, patients completed several emotional state questionnaires: HADS, MOOD, and CCVEII. Results. An improvement was observed in the following states of mind: sadness, fear, anger, and depression. No significant effect was observed in state of mind in terms of happiness or anxiety, in the levels of cortisol in hair, and in patients’ perceived quality of life. A reduction in cortisol was observed in saliva, although this did not significantly affect the IgA titer. Conclusions. BMGIM seems to improve the emotional state of patients with IBD.

11 ENTERAL NUTRITION THERAPY IS ASSOCIATED WITH FEWER READMISSIONS AND DEATHS AMONG MALNOURISHED INPATIENTS WITH INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S43-S44
Author(s):  
Wendi LeBrett ◽  
Jenny Sauk ◽  
Berkeley Limketkai
Keyword(s):  
Inflammatory Bowel Disease ◽  
Propensity Score ◽  
Enteral Nutrition ◽  
Bowel Disease ◽  
Nutrition Therapy ◽  
Control Group ◽  
Protein Calorie Malnutrition ◽  
Inflammatory Bowel ◽  
Matched Study ◽  
The Impact

Abstract Background Malnutrition is a common complication observed in hospitalized patients with inflammatory bowel disease (IBD). Enteral nutrition therapy can be used to support the nutritional needs of inpatients with IBD. However, evidence on the impact of inpatient enteral nutrition on clinical outcomes is equivocal. This study assesses post-hospitalization outcomes associated with enteral nutrition therapy amongst inpatients with IBD in a large nationwide database. Methods We conducted a retrospective propensity score-matched study among IBD inpatients diagnosed with protein-calorie malnutrition using the Nationwide Readmissions Database from 2010–2015. ICD9 codes associated with each admission were used to identify patients who received enteral nutrition. Using propensity score matching, patients who received inpatient enteral nutrition were matched with patients who did not receive enteral nutrition based on the following variables: age, sex, elective admission, patient income, teaching hospital, and hospital urban or rural locality. Primary endpoints included 30-day readmissions, 90-day readmissions, 30-day mortality and 90-day mortality. Results Among the 1,588 IBD patients (822 Crohn’s disease, 755 ulcerative colitis, 11 unclassified IBD) with protein-calorie malnutrition, patients who received enteral nutrition (n=794) had fewer 30-day readmissions (OR 0.73; 95% CI 0.55 – 0.96) and 90-day readmissions (OR 0.77; 95% CI 0.61 – 0.97). None of the patients (0%) in the enteral nutrition group died on a subsequent admission within 30 days of discharge, compared to 6 patients (0.8%) in the control group (p=0.027). Inpatient mortality within 90 days of discharge did not differ significantly between the two groups (0.8%, enteral nutrition vs. 1.6%, control; p=0.086). Discussion Enteral nutrition therapy among IBD inpatients with malnutrition was associated with lower odds of readmission and 30-day mortality, but not 90-day mortality. The findings of our study support the use of enteral nutrition in IBD inpatients and motivate the need for prospective studies assessing the impact of enteral nutritional support in IBD inpatients.

scholarly journals Improving maintenance medication adherence in adult inflammatory bowel disease patients: a pilot study

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Michelle L. Matteson-Kome ◽  
Jessica Winn ◽  
Matthew L. Bechtold ◽  
Jack D. Bragg ◽  
Cynthia L. Russell
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Pilot Study ◽  
Effect Size ◽  
Bowel Disease ◽  
Attention Control ◽  
Suboptimal Control ◽  
Control Group ◽  
Maintenance Medication ◽  
Inflammatory Bowel

Medication nonadherence in inflammatory bowel disease (IBD) may lead to suboptimal control of the disease, decreased quality of life, and poor outcomes. This pilot study evaluated the feasibility, intervention mechanism, and potential effectiveness of a three-month continuous self-improvement (CSI) intervention to enhance medication adherence (MA) in adult nonadherent IBD patients. Adult IBD patients taking a daily or twice-daily dosed maintenance medication were screened electronically for two months to determine baseline MA levels. Nonadherent IBD participants were randomized to the CSI or the attention control (AC) intervention and monitored for three months. The CSI intervention consisted of a data evaluation and system refinement process in which system changes were identified and implemented. The AC group was given educational information regarding IBD disease process, extra-intestinal manifestations of IBD, and medical therapy. Demographic statistics, change scores for within and between- group differences, and effect size estimates were calculated. Nine nonadherent participants (medication adherence score <0.85) were eligible for randomization. The intervention was found feasible and acceptable. Although no statistically significant improvement in MA was found (P=0.14), adherence improved in 3 of 4 of the CSI group and 1 of 2 in the attention control group. The effect size calculation of 1.9 will determine the sample size for future study. The results of this pilot study showed the intervention was feasible and had a positive effect on MA change score and adherence levels. A larger fully powered study is needed to test of the effectiveness of this innovative intervention.

scholarly journals DIETARY MANIPULATION OF THE GUT MICROBIOME IN INFLAMMATORY BOWEL DISEASE PATIENTS: PROOF OF CONCEPT

2021 ◽  
Author(s):  
Barbara Olendzki ◽  
Vanni Bucci ◽  
Caitlin Cawley ◽  
Rene Maserati ◽  
Margaret McManus ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Dietary Intervention ◽  
Predictive Analytics ◽  
Bacterial Species ◽  
Intestinal Microbiome ◽  
Post Intervention ◽  
Model Complex ◽  
Inflammatory Bowel ◽  
The Impact

ABSTRACTDiet is a modifiable, non-invasive, inexpensive behavior that is crucial in shaping the intestinal microbiome. A microbiome “imbalance” or dysbiosis in inflammatory bowel disease (IBD) is linked to inflammation. Here, we aim to define the impact of specific foods on bacterial species commonly depleted in patients with IBD to better inform dietary treatment. We performed a single-arm, pre-post intervention trial. After a baseline period, a dietary intervention with the IBD-Anti-Inflammatory Diet (IBD-AID) was initiated. We collected stool and blood samples and assessed dietary intake throughout the study. We applied advanced computational approaches to define and model complex interactions between the foods reported and the microbiome. A dense dataset comprising 553 dietary records and 340 stool samples was obtained from 22 participants. Consumption of prebiotics, probiotics, and beneficial foods correlated with increased abundance of Clostridia and Bacteroides, commonly depleted in IBD cohorts. We further show that the IBD-AID intervention affects the immune tone by lowering IL-8 and increasing GM-CSF with certain foods correlating with levels of those cytokines. By using robust predictive analytics, this study represents the first steps to detangle diet-microbiome interactions to inform personalized nutrition for patients suffering from dysbiosis-related IBD.

scholarly journals Exploitation of Marine-Derived Robust Biological Molecules to Manage Inflammatory Bowel Disease

Marine Drugs ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 196
Author(s):  
Muhammad Bilal ◽  
Leonardo Vieira Nunes ◽  
Marco Thúlio Saviatto Duarte ◽  
Luiz Fernando Romanholo Ferreira ◽  
Renato Nery Soriano ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bioactive Compounds ◽  
Bowel Disease ◽  
Clinical Translation ◽  
Biologically Active ◽  
Naturally Occurring ◽  
Inflammatory Bowel ◽  
Functional Features ◽  
Biological Entities ◽  
The Impact

Naturally occurring biological entities with extractable and tunable structural and functional characteristics, along with therapeutic attributes, are of supreme interest for strengthening the twenty-first-century biomedical settings. Irrespective of ongoing technological and clinical advancement, traditional medicinal practices to address and manage inflammatory bowel disease (IBD) are inefficient and the effect of the administered therapeutic cues is limited. The reasonable immune response or invasion should also be circumvented for successful clinical translation of engineered cues as highly efficient and robust bioactive entities. In this context, research is underway worldwide, and researchers have redirected or regained their interests in valorizing the naturally occurring biological entities/resources, for example, algal biome so-called “treasure of untouched or underexploited sources”. Algal biome from the marine environment is an immense source of excellence that has also been demonstrated as a source of bioactive compounds with unique chemical, structural, and functional features. Moreover, the molecular modeling and synthesis of new drugs based on marine-derived therapeutic and biological cues can show greater efficacy and specificity for the therapeutics. Herein, an effort has been made to cover the existing literature gap on the exploitation of naturally occurring biological entities/resources to address and efficiently manage IBD. Following a brief background study, a focus was given to design characteristics, performance evaluation of engineered cues, and point-of-care IBD therapeutics of diverse bioactive compounds from the algal biome. Noteworthy potentialities of marine-derived biologically active compounds have also been spotlighted to underlying the impact role of bio-active elements with the related pathways. The current review is also focused on the applied standpoint and clinical translation of marine-derived bioactive compounds. Furthermore, a detailed overview of clinical applications and future perspectives are also given in this review.

scholarly journals Dental and periodontal disease in patients with inflammatory bowel disease

2021 ◽  
Author(s):  
Christopher X. W. Tan ◽  
Henk S. Brand ◽  
Bilgin Kalender ◽  
Nanne K. H. De Boer ◽  
Tymour Forouzanfar ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Periodontal Disease ◽  
Bowel Disease ◽  
Health Problems ◽  
Control Group ◽  
Age And Gender ◽  
Preventive Dental Care ◽  
Dmft Index ◽  
Inflammatory Bowel ◽  
And Gender

Abstract Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.

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