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    Quality improvement project identifies factors associated with delay in IBD diagnosis

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    URI
    https://rde.dspace-express.com/handle/11287/621527
    Author
    Walker, Gareth
    Lin, Simeng
    Chanchlani, Neil
    Thomas, Amanda
    Hendy, Peter
    Heerasing, Neel
    Moore, Lucy
    Chee, Desmond
    Bewshea, Claire
    Mays, Joseph
    Kennedy, Nicholas A.
    Ahmad, Tariq
    Goodhand, James R.
    Date
    2020-08
    Journal
    Alimentary Pharmacology and Therapeutics
    Type
    Journal Article
    Publisher
    Wiley
    DOI
    10.1111/apt.15885
    Rights
    © 2020 John Wiley & Sons Ltd
    Metadata
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    Abstract
    Background: Delay in the diagnosis of inflammatory bowel disease (IBD) is common and contemporary UK studies are lacking. Aim: To determine factors associated with, and the consequences of, a prolonged time to diagnosis in IBD. Methods: This quality improvement study included 304 adults with a new IBD diagnosis made between January 2014 and December 2017 across 49 general practices (GP) and gastroenterology secondary care services. Outcome measures were demographic, clinical and laboratory factors associated with a delayed time, defined as greater than upper quartile, to: (a) patient presentation (b) GP referral (c) secondary care diagnosis, and factors associated with a complicated disease course (hospitalisation and/or surgery and/or biologic treatment) in the year after diagnosis. Results: The median [IQR] diagnosis sub-intervals were: (a) patient = 2.1 months [0.9-5.1]; (b) GP = 0.3 months [0.0-0.9]; (c) secondary care = 1.1 months [0.5-2.1]. 50% of patients were diagnosed within 4 months and 92% were diagnosed within 2 years of symptom onset. Diagnostic delay was more common in Crohn's disease (7.6 months [3.1-15.0]) than ulcerative colitis (3.3 months [1.9-7.3]) (P < 0.001). Patients who presented as an emergency (P < 0.001) but not those with a delayed overall time to diagnosis (P = 0.35) were more likely to have a complicated disease course. Conclusion: Time to patient presentation is the largest component of time to IBD diagnosis. Emergency presentation is common and, unlike a delayed time to diagnosis, is associated with a complicated disease course.
    Citation
    Walker GJ et al. Quality improvement project identifies factors associated with delay in IBD diagnosis. Aliment Pharmacol Ther. 2020 Aug;52(3):471-480. doi: 10.1111/apt.15885. Epub 2020 Jun 23.
    Publisher URL
    https://doi.org/10.1111/apt.15885
    Note
    This article is available to RD&E staff via NHS OpenAthens (subject to any publisher embargo). Click on the Publisher URL, and log in with NHS OpenAthens if prompted.
    Collections
    • 2020 RD&E publications
    • Gastroenterology
    • Honorary contracts publications
    • Quality Improvement

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