Background: Although inflammatory bowel disease
(IBD) patients have been increasing and new thera-peutic options for IBD have
been developed, there are relatively few clinicians who specialize in IBD. Patients
treated by a non-specialist of IBD may not receive appropriate treatment.
This study aimed to compare disease and medication status between IBD patients
treated by a specialist and those treated by a non-specialist. Methods: Medical
charts of ambulating IBD patients in two hospitals were examined. All
patients in one hospital were treated by one of the IBD specialists, while in
the other hospital, patients were treated by one of the gastroenterologists who
was a non-specialist of IBD. Results: The numbers of IBD patients were 255
(hospital with specialists) and 74 (hospital without specialists),
respectively. Disease activity of the patients was not well-controlled in the
hospital without specialists compared to in the hospi- tal with specialists
(ulcerative colitis (UC): p = 0.0006
and Crohn’s disease: p = 0.012,
respectively). The proportion of UC patients who received an insufficient
dose of mesalazine (Pentasa < 3 g/day or Asacol < 3.6 g/day) was higher
in the hospital without specialists (47% vs. 15%, p < 0.0001). In the hospital without specialists, more patients
received long-term corticosteroids (UC: 23% vs. 5%, p < 0.0001), while fewer patients received immunomodulators (UC:
8% vs. 46%, p < 0.0001). Conclusions:
IBD patients of the hospital without specialists were not well-controlled and
were not prescribed appropriately with thera-peutic drugs. Fostering and
placement of the specialist of IBD is an urgent problem.
Cite this paper
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