Title |
Delays in Initiating Post-operative Prophylactic Biologic Therapy Are Common Among Crohn’s Disease Patients
|
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Published in |
Digestive Diseases and Sciences, June 2018
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DOI | 10.1007/s10620-018-5159-4 |
Pubmed ID | |
Authors |
Shirley Cohen-Mekelburg, Stephanie Gold, Yecheskel Schneider, Madison Dennis, Clara Oromendia, Heather Yeo, Fabrizio Michelassi, Ellen Scherl, Adam Steinlauf |
Abstract |
Studies have shown that prophylactic biologic therapy can reduce post-surgical Crohn's disease recurrence. We aimed to identify the frequency of delay and risk factors associated with a delay in the initiation of prophylactic post-surgical biologic therapy in high-risk patients. We performed a cohort study of Crohn's disease patients who underwent a bowel resection. We identified those at risk of recurrence and explored multiple characteristics for those with and without a delay post-operatively. A total of 84 patients were included in our analysis of which 69.0% had a greater than 4-week delay and 56.0% a greater than 8-week delay in post-surgical biologic prophylaxis. Publicly insured patients had a 100% delay in post-surgical prophylaxis initiation (p = 0.039, p = 0.003 at 4 and 8 weeks, respectively). Patients on a biologic pre-surgery were less likely to have a delay (p < 0.001) in post-operative prophylaxis. Care at an inflammatory bowel disease (IBD) center was associated with timely therapy when considering a post-operative immunomodulator or biologic strategy. There are a substantial number of delays in initiating post-operative prophylactic biologic therapy in high-risk patients. Identifying susceptible patients by insurance type or absence of pre-operative therapy can focus future improvement efforts. Additionally, consultation with IBD-specialized providers should be considered in peri-surgical IBD care. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 2 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 28 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 5 | 18% |
Student > Master | 4 | 14% |
Student > Doctoral Student | 3 | 11% |
Other | 1 | 4% |
Student > Ph. D. Student | 1 | 4% |
Other | 3 | 11% |
Unknown | 11 | 39% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 11 | 39% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 7% |
Unspecified | 1 | 4% |
Nursing and Health Professions | 1 | 4% |
Biochemistry, Genetics and Molecular Biology | 1 | 4% |
Other | 2 | 7% |
Unknown | 10 | 36% |