Subrata Ghosh1, Benjamin Pariente2, Diane R Mould3, Stefan Schreiber4, Joel Petersson5, Daniel Hommes6. 1. Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada. Electronic address: subrata.ghosh@albertahealthservices.ca. 2. Department of Hepatogastroenterology, Saint-Louis Hospital, Paris, France. 3. Projections Research Inc., Phoenixville, PA, USA. 4. Department of General Internal Medicine, Christian-Albrechts University, Kiel, Germany. 5. Global Medical Affairs Gastroenterology, AbbVie, Rungis, France. 6. Division of Digestive Diseases, University of California, Los Angeles, CA, USA.
Abstract
BACKGROUND AND AIMS: Inflammatory bowel diseases are part of a wider conglomeration of immune-mediated inflammatory diseases. New management approaches need to be developed as we understand more of the epidemiology and aetiology of inflammatory bowel diseases and medical care becomes more complex. METHODS: Selected new tools and approaches for improved management of inflammatory bowel diseases are presented, based on published evidence and clinical experience. RESULTS: Setting quality of care standards that are consistent across different inflammatory bowel disease care settings will be paramount and require collaboration between specialist and non-specialist centres. Alongside this, the value of care will need to be evaluated in terms of maximising outcomes over the entire care cycle for a patient. In moving towards a value-based approach to management, it is important to determine the progression rate of the disease by measuring cumulative bowel damage. As well as understanding the course of disease in individual patients, it is also becoming more feasible to individualise therapy and exploit drug pharmacology to achieve better and more long-term responses. Finally, it is timely to consider formal collaborations between specialists in immune-mediated inflammatory diseases to ensure more cohesive patient care. CONCLUSIONS: The potential for improved management of patients with inflammatory bowel diseases continues to increase as we look to understand when and how to intervene in the disease process and how to adopt a collaborative management approach that promotes networking and reduces heterogeneity of care across different care settings.
BACKGROUND AND AIMS: Inflammatory bowel diseases are part of a wider conglomeration of immune-mediated inflammatory diseases. New management approaches need to be developed as we understand more of the epidemiology and aetiology of inflammatory bowel diseases and medical care becomes more complex. METHODS: Selected new tools and approaches for improved management of inflammatory bowel diseases are presented, based on published evidence and clinical experience. RESULTS: Setting quality of care standards that are consistent across different inflammatory bowel disease care settings will be paramount and require collaboration between specialist and non-specialist centres. Alongside this, the value of care will need to be evaluated in terms of maximising outcomes over the entire care cycle for a patient. In moving towards a value-based approach to management, it is important to determine the progression rate of the disease by measuring cumulative bowel damage. As well as understanding the course of disease in individual patients, it is also becoming more feasible to individualise therapy and exploit drug pharmacology to achieve better and more long-term responses. Finally, it is timely to consider formal collaborations between specialists in immune-mediated inflammatory diseases to ensure more cohesive patient care. CONCLUSIONS: The potential for improved management of patients with inflammatory bowel diseases continues to increase as we look to understand when and how to intervene in the disease process and how to adopt a collaborative management approach that promotes networking and reduces heterogeneity of care across different care settings.
Authors: Miguel Regueiro; Benjamin Click; Alyce Anderson; William Shrank; Jane Kogan; Sandra McAnallen; Eva Szigethy Journal: Clin Gastroenterol Hepatol Date: 2018-04-12 Impact factor: 11.382