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Original Articles
- Lifestyle restrictions are associated with impaired quality of life but not reduction in relapse in ulcerative colitis
- Hajime Yamazaki, Masakazu Nagahori, Tadakazu Hisamatsu, Taku Kobayashi, Teppei Omori, Jimmy K. Limdi, John T. McLaughlin, Shu-Chen Wei, Jovelle Fernandez, Shunichi Fukuhara, Katsuyoshi Matsuoka
- Received November 29, 2024 Accepted March 18, 2025 Published online May 14, 2025
- DOI: https://doi.org/10.5217/ir.2024.00199 [Epub ahead of print]
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Abstract
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Supplementary Material
PubReader
ePub - Background/Aims
Patients with ulcerative colitis (UC) in remission commonly restrict thir lifestyle to prevent relapse; however, the effectiveness and impact on quality of life (QOL) is unclear. This study investigated whether lifestyle restrictions are associated with relapse reduction and assessed their impact on QOL.
Methods
This multicenter, prospective cohort study was conducted in Japan (2018–2021) via the YOURS registry, enrolling patients with UC in clinical remission. Patients were followed for 2 years. A baseline questionnaire evaluated lifestyle restrictions in diet, work/study/housework, and physical exercise. QOL was assessed by Disease Impact Scale every 3 months during the first year of follow-up. Associations of lifestyle restrictions with relapse and QOL were assessed by Cox regression analysis and linear mixed-effects models, respectively.
Results
Among 911 patients in clinical remission for > 90 days, 63% had adopted dietary avoidance; 47%, work/study/housework avoidance; and 8%, physical exercise avoidance. Overall, 216 patients relapsed. Lifestyle restrictions were not associated with reduced risk of relapse (multivariableadjusted hazard ratios [95% confidence interval]: dietary avoidance, 1.08 [0.81–1.44]; and work/study/housework avoidance, 1.14 [0.87–1.50]); physical exercise avoidance was associated with increased relapse (multivariable-adjusted hazard ratio, 1.58; 95% confidence interval, 1.02–2.44). All lifestyle restrictions were associated with impaired QOL (P <0.01).
Conclusions
Lifestyle restrictions were not associated with relapse reduction in patients with UC; however, they were associated with impaired QOL. Clinicians should engage in evidence-based discussions with patients with UC in remission regarding lifestyle restrictions (UMIN Clinical Trials Registry; UMIN000031995).
- 573 View
- 70 Download
- Health-related quality of life, work productivity, and persisting challenges in treated ulcerative colitis patients: a Japanese National Health and Wellness Survey
- Sakiko Hiraoka, Zhezhou Huang, Fei Qin, Fatima Megala Nathan Arokianathan, Kiran Davé, Shweta Shah, Hyunchung Kim
- Received July 2, 2024 Accepted October 23, 2024 Published online January 2, 2025
- DOI: https://doi.org/10.5217/ir.2024.00104 [Epub ahead of print]
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Despite available treatments for ulcerative colitis (UC), unmet needs persist among patients in Japan. This study explored the health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), indirect cost, and unmet needs among treated UC patients in Japan.
Methods
This cross-sectional, observational study utilized data from the online 2017, 2019, and 2021 Japan National Health and Wellness Survey. Respondents were aged ≥ 18 years and had undergone or were on UC treatment (5-aminosalicylic acid, steroids, immunomodulators/immunosuppressants, biologics/Janus kinase inhibitors [JAKi]). Demographic, general health, and clinical characteristics, medication adherence, HRQoL, WPAI, and indirect cost were collected and analyzed.
Results
Among 293 treated UC patients, 83.6% were non-biologic/JAKi users, 29.0% had UC ≥ 15 years, 34.8% had moderate-to-severe disease severity, 55.3% experienced ≥ 1 persisting UC symptom, and 91.5% reported UC as bothersome to an extent. Patients reported EuroQoL visual analog scale score of 68.1 and ≥ 35% reported anxiety and depression. Mean work productivity loss was 29.3%, resulting in an annual mean indirect loss of 1.1 million JPY (45.3 thousand USD) per person. Higher WPAI (impairment) was associated with being male, moderate-to-severe disease severity, and low treatment adherence (P< 0.05). Biologics/JAKi users had higher work impairment, and IM/IS users had higher activity impairment than 5-aminosalicylic acid users (P< 0.05).
Conclusions
Despite treatment, Japanese UC patients experienced high disease burden and persistent disease-related challenges. Overall HRQoL were lower than the mean healthy population and work productivity impairment led to high indirect costs. The findings suggest the importance of new interventions for optimizing UC outcomes.
- 1,929 View
- 203 Download
- IBD
- Early resolution of bowel urgency by budesonide foam enema results in improved quality of life in patients with ulcerative colitis: a multicenter prospective observational study
- Taku Kobayashi, Kei Moriya, Toshimitsu Fujii, Shigeki Bamba, Shinichiro Shinzaki, Akihiro Yamada, Takashi Hisabe, Shintaro Sagami, Shuji Hibiya, Takahiro Amano, Noritaka Takatsu, Katsutoshi Inagaki, Ken-ichi Iwayama, Toshifumi Hibi
- Intest Res 2025;23(2):157-169. Published online July 15, 2024
- DOI: https://doi.org/10.5217/ir.2024.00005
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Bowel urgency is an important symptom for quality of life determination in patients with ulcerative colitis (UC). Few clinical studies have focused on bowel urgency as an efficacy endpoint. Budesonide foam enema has shown efficacy for clinical and endoscopic improvement in mild-to-moderate UC. We evaluated the improvement of clinical symptoms (bowel urgency), safety, and treatment impact of twice-daily budesonide foam enema on the quality of life in patients with UC.
Methods
This open-label, multicenter, prospective observational study comprised a 4-week observation period assessing the effectiveness and safety of twice-daily budesonide foam enema. Mild-to-moderate UC patients who had bowel urgency were included. Patients collected data daily in an electronic patient-reported outcome system or logbooks. The primary endpoint was the rate of resolution of bowel urgency at the end of the 4-week observation period. The rate of bowel incontinence was also assessed.
Results
Sixty-one patients were enrolled. Of patients with a final evaluation, the rate of resolution of bowel urgency was 58.5% (31/53; 95% confidence interval, 44.1%–71.9%). Bowel urgency decreased over time, with a significant difference observed on day 7 versus day 0. Bowel incontinence showed a decreasing trend from day 5, with a significant difference confirmed on day 12 versus day 0. The clinical remission rate was 64.4% (38/59; 95% confidence interval, 50.9%–76.4%). One adverse event not related to budesonide rectal foam occurred.
Conclusions
The findings suggest that bowel urgency can be improved early with twice-daily budesonide foam enema. No new safety signals were observed.
- 3,083 View
- 295 Download
- IBD
- Insomnia is common in inflammatory bowel disease (IBD) and is associated with mental health conditions as well as IBD activity
- Alex Barnes, Jane M Andrews, Sutapa Mukherjee, Robert V Bryant, Peter Bampton, Robert J. Fraser, Réme Mountifield
- Intest Res 2024;22(1):104-114. Published online November 1, 2023
- DOI: https://doi.org/10.5217/ir.2023.00028
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Insomnia is common in people with chronic medical conditions, such as inflammatory bowel disease (IBD), and is readily treatable through cognitive behavioral therapy for insomnia. This study aimed to describe the associations with insomnia in people with IBD and its relationship to IBD-related disability.
Methods
An online questionnaire was administered through 3 tertiary IBD centers, social media, and Crohn’s Colitis Australia. The questionnaire included the Insomnia Severity Index (ISI), a validated assessment of insomnia. Measures of anxiety, depression, physical activity, and disability were also included. IBD activity was assessed using validated patient reported scores. A multivariate model was constructed for clinically significant insomnia and ISI scores. Subpopulations of Crohn’s disease and ulcerative colitis were considered.
Results
In a cohort of 670 respondents the median age was 41 years (range, 32–70 years), with the majority female (78.4%), the majority had Crohn’s disease (57.3%). Increasingly severe disability was associated with worse insomnia score. Clinically significant insomnia was associated with clinically active IBD, abdominal pain, anxiety, and depression, in a multivariate model. In an ulcerative colitis population, Simple Clinical Colitis Activity Index components of general well-being and urgency were associated with worse ISI score in a model including depression and anxiety. In those with Crohn’s disease, the multivariate model included Harvey Bradshaw Index score in addition to depression and anxiety.
Conclusions
Insomnia is common in people with IBD and is associated with increased disability. Abdominal pain and mental health conditions should prompt consideration for screening for insomnia and referral for cognitive behavioral therapy for insomnia. -
Citations
Citations to this article as recorded by
- The IBD Clinic of Tomorrow: Holistic, Patient-Centric, and Value-based Care
Benjamin Click, Raymond K. Cross, Miguel Regueiro, Laurie Keefer
Clinical Gastroenterology and Hepatology.2025; 23(3): 419. CrossRef - Chronic Poor Sleep is Associated with Increased Disease Activity in Patients with Ulcerative Colitis: Prospective Observational Study in Japan
Hideaki Oyama, Rintaro Moroi, Atsushi Sakuma, Yusuke Shimoyama, Hiroshi Nagai, Takeo Naito, Hisashi Shiga, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
Journal of Crohn's and Colitis.2025;[Epub] CrossRef - Association between depression and anxiety with the risk and flare of inflammatory bowel disease: a systematic review and meta-analysis
Guowei Gong, Cong Xu, Zhenxia Zhang, Yuzhong Zheng
Internal and Emergency Medicine.2025; 20(1): 35. CrossRef - The impact of sleep quality on the prognosis of inflammatory bowel disease commonly overlooked by gastroenterologists
Ji Young Chang
Intestinal Research.2024; 22(1): 5. CrossRef - Sleep quality is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain
Alex Barnes, Robert V Bryant, Sutapa Mukherjee, Paul Spizzo, Réme Mountifield
JGH Open.2024;[Epub] CrossRef - Abdominal Pain in Inflammatory Bowel Disease-Epidemiology, Pathophysiology, and Management: A Narrative Review
Wei-wei Tan, Zi-xuan Liu, Xiao-Yan Liu, Wei-bing Zhang, Lie Zheng, Ya-Li Zhang, Yan-Cheng Dai
Pain and Therapy.2024; 13(6): 1447. CrossRef - Impact of Inflammatory Bowel Disease on Patient’s Quality of Life – A Review
Kamila Duszyńska, Karol Dolepski, Alicja Góral, Krystian Żuk, Michał Czachajda
Journal of Health Study and Medicine.2024; 2024(1): 185. CrossRef
- The IBD Clinic of Tomorrow: Holistic, Patient-Centric, and Value-based Care
- 4,961 View
- 285 Download
- 6 Web of Science
- 7 Crossref
- Inflammatory Bowel Diseases
- Quality of life in inflammatory bowel diseases: it is not all about the bowel
- Ronald Keller, Nazar Mazurak, Laura Fantasia, Stefano Fusco, Nisar P Malek, Jan Wehkamp, Paul Enck, Thomas Klag
- Intest Res 2021;19(1):45-52. Published online February 27, 2020
- DOI: https://doi.org/10.5217/ir.2019.00135
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
The inflammatory bowel diseases (IBD), ulcerative colitis (UC), and Crohn’s disease (CD) are chronic diseases mostly affecting young patients. As they are diseases accompanying patients for their entire life, and the quality of life (QUOL) interacts with disease activity, improving QUOL should be one of the main goals of therapy. This study aims to identify factors contributing to good or impaired QUOL.
Methods
Questionnaires addressing health-related QUOL and other psychological and social features were positioned on our institutions’ webpage and on the webpage of the largest self-help group for IBD in Germany. Patients were subdivided according to their QUOL score with a cutoff of <60. We used the Short Inflammatory Bowel Disease Questionnaire, the Assessment of the Demand for Additional Psychological Treatment, and the Fear of Progression Questionnaire Short Form.
Results
High numbers of patients in both subgroups showed an impaired QUOL (87.34% in UC, 91.08% in CD). Active extraintestinal manifestations, smoking, high fear of progression and high demand for psychotherapy were associated with reduced QUOL. In addition, polypharmacological interventions did not result in a good QUOL, but ostomies are linked to improved QUOL especially in CD patients.
Conclusions
Scores used in clinical day-to-day-practice mainly focusing on somatic factors do not sufficiently address important aspects concerning QUOL. Most importantly, extraintestinal manifestations show a hitherto underestimated impact on QUOL. -
Citations
Citations to this article as recorded by- Evaluation of the Effect of Probiotic Supplementation on Intestinal Barrier Integrity and Epithelial Damage in Colitis Disease: A Systematic Review
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Alex Barenboim, Tali Epstein Weiss, Orestis Argyriou, Nathaniel Aviv Cohen, Yehuda Kariv, Meir Zemel, Eran Itzkowitz, Ron Greenberg, Noam Goder, Sara Borok, Kapil Sahnan, Hagit Tulchinsky, Nitsan Maharshak
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Scandinavian Journal of Gastroenterology.2025; 60(6): 558. CrossRef - Eosinophilic esophagitis patients report substantial disease burden comparable to more systemic immune-mediated diseases
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Inflammatory Bowel Diseases.2025;[Epub] CrossRef - Beyond the Gut: A Systematic Review and Meta-analysis of Advanced Therapies for Inflammatory Bowel Disease-associated Extraintestinal Manifestations
Ágnes Eszter Tímár, Andrea Párniczky, Kinga Anna Budai, Márk Viktor Hernádfői, Emese Kasznár, Péter Varga, Péter Hegyi, Szilárd Váncsa, Réka Tóth, Dániel Sándor Veres, Miklós Garami, Katalin Eszter Müller
Journal of Crohn's and Colitis.2024; 18(6): 851. CrossRef - The association between fear of progression and medical coping strategies among people living with HIV: a cross-sectional study
Bing Li, Xiaoli Lin, Suling Chen, Zhe Qian, Houji Wu, Guichan Liao, Hongjie Chen, Zixin Kang, Jie Peng, Guangyu Liang
BMC Public Health.2024;[Epub] CrossRef - Relationship between fear of progression and quality of life in inflammatory bowel disease: Mediating role of health literacy and self‐care
Xin Hu, Liyuan Xu
Journal of Advanced Nursing.2024; 80(10): 4147. CrossRef - Risk Factors of Pneumocystis jirovecii Pneumonia in Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
Jiyoung Yoon, Seung Wook Hong, Kyung-Do Han, Seung-Woo Lee, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Joo Sung Kim, Hyuk Yoon
Gut and Liver.2024; 18(3): 489. CrossRef - Nutritional Profile, Disease Severity, and Quality of Life of Patients with Inflammatory Bowel Disease: A Case–Control Study
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E-Liisa Laakso, Tatjana Ewais
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Medical Journal of Indonesia.2023; 32(3): 168. CrossRef - Prediction of Clinical Remission with Adalimumab Therapy in Patients with Ulcerative Colitis by Fourier Transform–Infrared Spectroscopy Coupled with Machine Learning Algorithms
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Vítor Macedo Silva, Marta Freitas, Pedro Boal Carvalho, Francisca Dias de Castro, Tiago Cúrdia Gonçalves, Bruno Rosa, Maria João Moreira, José Cotter
Digestive Diseases and Sciences.2022; 67(4): 1278. CrossRef - Study on the impact of sexually transmitted infections on Quality of Life, mood and sexual function
Giulia CICCARESE, Francesco DRAGO, Francesco COPELLO, Giorgia BODINI, Alfredo REBORA, Aurora PARODI
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Catherine Rowan, Ryan Ungaro, Saurabh Mehandru, Jean-Frederic Colombel
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Ji Eun Ryu, Sung-Goo Kang, Sung Hoon Jung, Shin Hee Lee, Sang-Bum Kang
Journal of Clinical Medicine.2022; 11(11): 3034. CrossRef - The future of telemedicine and wearable technology in IBD
Catherine Rowan, Robert Hirten
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Jaeyoung Chun
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- Evaluation of the Effect of Probiotic Supplementation on Intestinal Barrier Integrity and Epithelial Damage in Colitis Disease: A Systematic Review
- 10,179 View
- 343 Download
- 32 Web of Science
- 33 Crossref
Review
- IBD
- Improving the quality of care for inflammatory bowel disease
- Byong Duk Ye, Simon Travis
- Intest Res 2019;17(1):45-53. Published online November 20, 2018
- DOI: https://doi.org/10.5217/ir.2018.00113
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Abstract
PDFPubReaderePub
- Great strides have been achieved in the development of quality-of-care measures and standards for inflammatory bowel disease (IBD) over the last decade. The central structural component of care in IBD revolves around the multidisciplinary team, which should be equipped with the necessary resources to operate and implement decisions. Process measures have been defined by interest groups and can be adapted into process tools for the delivery of care for various patient subgroups and clinical scenarios. The emerging treat-to-target approach to IBD management may be used to achieve optimal long-term and holistic patient-centred outcomes, such as survival, control of inflammation and disease progression, symptomatic remission, quality of life and complications. Other important quality-of-care outcome measures for IBD include disutility of care, healthcare utilization and other patient-reported outcomes such as nutritional status and impact of fistulae. The current challenge for healthcare providers and health systems is the integration of quality-of-care structures and processes into clinical practice, and the consistent delivery of updated evidence-based quality IBD care to various patient populations by individual health care providers. Finally, the awareness and appreciation for quality of care in IBD is increasing in Asia, and Asian healthcare institutions should be encouraged to take the lead in improving the quality of care in IBD.
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Citations
Citations to this article as recorded by- Quality of care and satisfaction of users attended by interns of the Growth and Development Control area
Allison Alvarez-Tello, Lesly Abigail Cayo-Fernández
South Health and Policy.2026; 5: 376. CrossRef - Improving access to inflammatory bowel disease care in Canada: The patient experience
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Noelle Rohatinsky, Natasha Tooke, Sharyle Fowler, Christian Rueda-Clausen, Dirk Morrison, Judith Winchester, Juan-Nicolás Peña-Sánchez
Journal of the Canadian Association of Gastroenterology.2024; 7(5): 384. CrossRef - Person-Centered Coordinated Care Experience of People With Long-Term Conditions in the Balearic Islands Measured by the P3CEQ
Gabriel Mercadal-Orfila, Salvador Herrera-Pérez, Núria Piqué, Francesc Mateu-Amengual, Pedro Ventayol-Bosch, Maria Antonia Maestre-Fullana, Joaquin Ignacio Serrano-López de las Hazas, Francisco Fernández-Cortés, Francesc Barceló- Sansó, Santiago Rios
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Graham Johnson
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Padhmanand Sudhakar, Judith Wellens, Bram Verstockt, Marc Ferrante, João Sabino, Séverine Vermeire
Gut.2023; 72(1): 192. CrossRef - The cost of inflammatory bowel disease in high-income settings: a Lancet Gastroenterology & Hepatology Commission
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Journal of the Canadian Association of Gastroenterology.2023; 6(Supplement): S111. CrossRef - Der IBD-Control-Fragebogen: Deutsche Übertragung und Validierung des standardisierten Fragebogens zur Messung des Outcomes aus Patientensicht bei chronisch entzündlichen Darmerkrankungen
Annabell Müller, Selina Simone Bilger, Andreas Göldi, Gunther Meinlschmidt, Florian Rueter, Alexander Kappes, Petr Hruz, Christoph Andreas Meier, Jan Hendrik Niess
Zeitschrift für Gastroenterologie.2022; 60(06): 911. CrossRef - High Risk of Fractures Within 7 Years of Diagnosis in Asian Patients With Inflammatory Bowel Diseases
Hyung Jin Ahn, Ye-Jee Kim, Ho-Su Lee, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Beom-Jun Kim, Sang Hyoung Park
Clinical Gastroenterology and Hepatology.2022; 20(5): e1022. CrossRef - Appendiceal Orifice Inflammation Is Associated with Lower Rate of Complete Endoscopic Remission in Patients with Ulcerative Colitis
Chang Kyo Oh, Han Hee Lee, Jin Su Kim, Bo-In Lee, Young-Seok Cho
Journal of Personalized Medicine.2022; 12(5): 748. CrossRef - Risk of Hepatitis B Virus (HBV) Reactivation in Patients with Immune-Mediated Inflammatory Diseases Receiving Biologics: Focus on the Timing of Biologics after Anti-HBV Treatment
Soo Min Ahn, Jonggi Choi, Byong Duk Ye, Suk-Kyun Yang, Ji Seon Oh, Yong‑Gil Kim, Chang-Keun Lee, Bin Yoo, Sang Hyoung Park, Seokchan Hong
Gut and Liver.2022; 16(4): 567. CrossRef - Clinical Remission and Psychological Management are Major Issues for the Quality of Life in Pediatric Crohn Disease
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Asim Kichloo, Zain El-amir, Dushyant Singh Dahiya, Farah Wani, Hafeez Shaka
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Jun Lee
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Original Articles
- IBD
- Health-related quality of life of patients with inflammatory bowel disease in Singapore
- Prisca Yue Min Ho, Wenjia Hu, Ying Yun Lee, Chuxi Gao, Yan Zhi Tan, Hua Heng Cheen, Hwee Lin Wee, Teong Guan Lim, Wan Chee Ong
- Intest Res 2019;17(1):107-118. Published online November 12, 2018
- DOI: https://doi.org/10.5217/ir.2018.00099
-
Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Inflammatory bowel disease (IBD) is associated with considerable impairment of patients’ health-related quality of life (HRQoL). Knowledge of factors that significantly affect IBD patients’ HRQoL can contribute to better patient care. However, the HRQoL of IBD patients in non-Western countries are limited. Hence, we assessed the HRQoL of Singaporean IBD patients and identified its determinants.
Methods
A prospective, cross-sectional study was conducted at Singapore General Hospital outpatient IBD Centre. The HRQoL of IBD patients was assessed using the short IBD questionnaire (SIBDQ), Short Form-36 physical and mental component summary (SF-36 PCS/MCS) and EuroQol 5-dimensions 3-levels (EQ-5D-3L) and visual analogue scale (VAS). Independent samples t-test was used to compare HRQoL between Crohn’s disease (CD) and ulcerative colitis (UC). Determinants of HRQoL were identified through multiple linear regression.
Results
A total of 195 IBD patients (103 UC, 92 CD) with a mean disease duration of 11.2 years were included. There was no significant difference in HRQoL between patients with UC and CD. Factors that significantly worsened HRQoL were presence of active disease (b=−6.293 [SIBDQ], −9.409 [PCS], −9.743 [MCS], −7.254 [VAS]), corticosteroids use (b=−7.392 [SIBDQ], −10.390 [PCS], −8.827 [MCS]), poor medication adherence (b=−4.049 [SIBDQ], −1.320 [MCS], −8.961 [VAS]), presence of extraintestinal manifestations (b=−13.381 [PCS]), comorbidities (b=−4.531 [PCS]), non-employment (b=−9.738 [MCS], −0.104 [EQ-5D-3L]) and public housing (b=−8.070 [PCS], −9.207 [VAS]).
Conclusions
The HRQoL is impaired in this Asian cohort of IBD. The magnitude of HRQoL impairment was similar in UC and CD. Clinical characteristics were better determinants of patients’ HRQoL than socio-demographic factors. Recognizing the factors that impact patients’ HRQoL would improve the holistic management of IBD patients. -
Citations
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Elizabeth Dent, Nicola Davinson, Stephanie Wilkie
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Ziyun Gao, Pei Wang, Jie Hong, Yuqing Yan, Tianying Tong, Bin Wu, Jun Hu, Zhenhua Wang
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Hasan Aladraj, Mohamed Abdulla, Salman Yousuf Guraya, Shaista Salman Guraya
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Daren Low, Nidhi Swarup, Toshiyuki Okada, Emiko Mizoguchi
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Kasenee Tiankanon, Julajak Limsrivilai, Napapat Poocharoenwanich, Phutthaphorn Phaophu, Nichcha Subdee, Natanong Kongtub, Satimai Aniwan
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- Endoscopy
- The current capacity and quality of colonoscopy in Korea
- Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin
- Intest Res 2019;17(1):119-126. Published online October 10, 2018
- DOI: https://doi.org/10.5217/ir.2018.00060
-
Abstract
PDFPubReaderePub
- Background/Aims
Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea.
Methods
We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals.
Results
Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios.
Conclusions
The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea. -
Citations
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World Journal of Gastrointestinal Oncology.2024; 16(1): 51. CrossRef - Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
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Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef - Faecal immunochemical tests can improve colonoscopy triage in patients with iron deficiency: A systematic review and meta-analysis
Jennifer Pham, Geraldine Laven-Law, Erin L. Symonds, Molla M. Wassie, Charles Cock, Jean M. Winter
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Gastroenterology Research and Practice.2022; 2022: 1. CrossRef - Risk of Metachronous Colorectal Advanced Neoplasia and Cancer in Patients With 3–4 Nonadvanced Adenomas at Index Colonoscopy: A Systematic Review and Meta-Analysis
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Jin Wook Lee, Hyo Jeong Lee, Dae Sung Kim, Jiyoung Yoon, Seung Wook Hong, Ha Won Hwang, Jong-Soo Lee, Gwang-Un Kim, Sinwon Lee, Jaewon Choe, Jin Hwa Park, Dong-Hoon Yang, Jeong-Sik Byeon
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Su Bee Park, Jae Myung Cha
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Kyeongmin Lee, Haejoo Seo, Sunho Choe, Seung-Yong Jeong, Ji Won Park, Mina Suh, Aesun Shin, Kui Son Choi, Filipe Prazeres
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Jae Gon Lee, Dong Soo Han, Young-Eun Joo, Dae-Seong Myung, Dong Il Park, Seul Ki Kim, Yunho Jung, Won Hyun Lee, Eun Soo Kim, Joon Seok Yoon, Chang Soo Eun
The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S35. CrossRef - Real-World National Colonoscopy Volume in Korea: A Nationwide Population-Based Study over 12 Years
Jae Myung Cha, Min Seob Kwak, Hyun-Soo Kim, Su Young Kim, Sohee Park, Geun U Park, Jung Kuk Lee, Soo Jin Kim, Hun Hee Lee, Joo Sung Kim, Won Ho Kim
Gut and Liver.2020; 14(3): 338. CrossRef
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- 13,491 View
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- IBD
- IBD2020 global forum: results of an international patient survey on quality of care
- Peter Irving, Johan Burisch, Richard Driscoll, Mats Olsson, John R Fullarton, Barry S Rodgers-Gray, Simon PL Travis
- Intest Res 2018;16(4):537-545. Published online October 10, 2018
- DOI: https://doi.org/10.5217/ir.2018.00041
-
Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
IBD2020 is a global forum for standards of care in inflammatory bowel disease (IBD). The aim of the IBD2020 survey was to identify and describe variations in quality care of IBD.
Methods
Patients with IBD from Finland, Italy, France, Canada, Germany, UK, Spain and Sweden were surveyed during 2013 to 2014, covering: disease characteristics; impact on life and work; organization and perceived quality of care.
Results
Seven thousand five hundred and seven patients participated (median age, 39 years [range, 10–103 years]; 2,354 male [31.4%]), including 4,097 (54.6%) with Crohn’s disease (CD) and 3,410 (45.4%) with ulcerative colitis (UC). Median time from symptom onset to diagnosis was 1 year for both CD (range, 0–47 years) and UC (range, 0–46 years), with no clear evidence of improvement in diagnostic delay over the preceding 24 years. Half of the patients (3,429; 50.0%) rated their care as “excellent” or “very good,” with similar results for CD and UC across countries. Five factors were significantly (P<0.01) associated with perceived good quality of care: quality of specialist communication; review consultation being long enough; failure to share information; no access to a dietician; speed of advice.
Conclusions
The IBD2020 survey has highlighted areas related to quality of care of IBD from the patients’ perspective, with scope for improvement. -
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- Endoscopy
- Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice
- Dae Hyung Woo, Kyeong Ok Kim, Da Eun Jeong, Yoon Jeong Nam, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
- Intest Res 2018;16(2):293-298. Published online April 30, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.2.293
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice.
Methods We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation.
Results Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake <2 L were the independent predictors of inadequate bowel preparation.
Conclusions The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.
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Citations
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Reviews
- Endoscopy
- Quality is the key for emerging issues of population-based colonoscopy screening
- Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen
- Intest Res 2018;16(1):48-54. Published online January 18, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.1.48
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Abstract
PDFPubReaderePub
Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.
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- IBD
- Quality indicators in inflammatory bowel disease
- Sameer K. Berry, Gil Y. Melmed
- Intest Res 2018;16(1):43-47. Published online January 18, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.1.43
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Abstract
PDFPubReaderePub
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic, debilitating, and expensive condition affecting millions of people globally. There is significant variation in the quality of care for patients with IBD across North America, Europe, and Asia; this variation suggests poor quality of care due to overuse, underuse, or misuse of health services and disparity of outcomes. Several initiatives have been developed to reduce variation in care delivery and improve processes of care, patient outcomes, and reduced healthcare costs. These initiatives include the development of quality indicator sets to standardize care across organizations, and learning health systems to enable data sharing between doctors and patients, and sharing of best practices among providers. These programs have been variably successful in improving patient outcomes and reducing healthcare utilization. Further studies are needed to demonstrate the long-term impact and applicability of these efforts in different geographic areas around the world, as regional variations in patient populations, societal preferences, and costs should inform local quality improvement efforts.
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Original Articles
- Impact of inflammatory bowel disease on daily life: an online survey by the Korean Association for the Study of Intestinal Diseases
- Young Sun Kim, Sung-Ae Jung, Kang-Moon Lee, Soo Jung Park, Tae Oh Kim, Chang Hwan Choi, Hyun Gun Kim, Won Moon, Chang Mo Moon, Hye Kyoung Song, Soo-Young Na, Suk-Kyun Yang
- Intest Res 2017;15(3):338-344. Published online June 12, 2017
- DOI: https://doi.org/10.5217/ir.2017.15.3.338
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Abstract
PDFSupplementary MaterialPubReaderePub
<b>Background/Aims</b><br/> Inflammatory bowel disease (IBD) is a chronic disabling gastrointestinal disorder that diminishes the quality of life of the affected individuals. Limited data are available regarding the impact of IBD on the daily life of Koreans.
Methods Self-administered, computer-aided, internet-based questionnaires were distributed to members of a Korean patient organization for IBD from March to April 2013, by the Korean Association for the Study of Intestinal Diseases.
Results A total of 599 patients with IBD (387 with Crohn's disease [CD] and 212 with ulcerative colitis [UC]) were enrolled. The majority of patients (81%) expressed feelings of fatigue, weakness, and being worn out in their daily lives during times of flare; this percentage was reduced to 61% during remission. Respondents were absent from work or school for an average period of 18 days because of illness, within the first 6 months; the majority of respondents (64%) felt stressed about their absence. Forty-six percent of the respondents reported having received unfair comments at work, or having suffered discrimination. Forty-seven percent of the respondents felt that IBD had negatively affected their income and earnings. Compared with patients with UC, those with CD reported a more frequent negative impact of IBD on work, or more economic burden. More than half of the respondents (61%) reported that IBD had prevented them from making or keeping friends.
Conclusions IBD significantly impacts daily life, including work, education, and social relationships. Treatment that addresses the full spectrum of life of a patient would be more effective.
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Gastrointestinal Nursing.2020; 18(5): 42. CrossRef - Unmet Psychosocial Needs of Patients with Newly Diagnosed Ulcerative Colitis: Results from the Nationwide Prospective Cohort Study in Korea
Jung Rock Moon, Chang Kyun Lee, Sung Noh Hong, Jong Pil Im, Byong Duk Ye, Jae Myung Cha, Sung-Ae Jung, Kang-Moon Lee, Dong Il Park, Yoon Tae Jeen, Young Sook Park, Jae Hee Cheon, Hyesung Kim, BoJeong Seo, Youngdoe Kim, Hyo Jong Kim
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European Journal of Gastroenterology & Hepatology.2020; 32(12): 1514. CrossRef - Preconception Care Program for Women with Inflammatory Bowel Disease Using Intervention Mapping: A Protocol for Program Development
Young Jin Lee, Yeon Hee Kim, Hae Won Kim
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World Journal of Gastroenterology.2019; 25(17): 2071. CrossRef - EpidemIBD: rationale and design of a large-scale epidemiological study of inflammatory bowel disease in Spain
María Chaparro, Manuel Barreiro-de Acosta, José Manuel Benítez, José Luis Cabriada, María José Casanova, Daniel Ceballos, María Esteve, Hipólito Fernández, Daniel Ginard, Fernando Gomollón, Rufo Lorente, Pilar Nos, Sabino Riestra, Montserrat Rivero, Pilar
Therapeutic Advances in Gastroenterology.2019;[Epub] CrossRef - Application of Herbaceous Medications for Inflammatory Bowel Disease as a Complementary and Alternative Therapy
Zili Lin, Huiyi Wu, Yiming Fu, Shixue Dai
Inflammatory Bowel Diseases.2019; 25(12): 1886. CrossRef - Analysis of the Nutrients and Food Products Intake of Polish Males with Ulcerative Colitis in Remission
Dominika Głąbska, Dominika Guzek, Gustaw Lech
Nutrients.2019; 11(10): 2333. CrossRef - Are there also negative effects of social support? A qualitative study of patients with inflammatory bowel disease
Alexander Palant, Wolfgang Himmel
BMJ Open.2019; 9(1): e022642. CrossRef - Reactive Oxygen Species Deficiency Due to Ncf1-Mutation Leads to Development of Adenocarcinoma and Metabolomic and Lipidomic Remodeling in a New Mouse Model of Dextran Sulfate Sodium-Induced Colitis
Lina Carvalho, Joana R. M. Gomes, Ludgero C. Tavares, Ana R. Xavier, Karel D. Klika, Rikard Holmdahl, Rui A. Carvalho, M. Margarida Souto-Carneiro
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Complementary Therapies in Medicine.2018; 40: 77. CrossRef - IBD2020 global forum: results of an international patient survey on quality of care
Peter Irving, Johan Burisch, Richard Driscoll, Mats Olsson, John R Fullarton, Barry S Rodgers-Gray, Simon PL Travis
Intestinal Research.2018; 16(4): 537. CrossRef - Association of Perianal Fistulas with Clinical Features and Prognosis of Crohn's Disease in Korea: Results from the CONNECT Study
Jaeyoung Chun, Jong Pil Im, Ji Won Kim, Kook Lae Lee, Chang Hwan Choi, Hyunsoo Kim, Jae Hee Cheon, Byong Duk Ye, Young-Ho Kim, You Sun Kim, Yoon Tae Jeen, Dong Soo Han, Won Ho Kim, Joo Sung Kim
Gut and Liver.2018; 12(5): 544. CrossRef
- Increased Risks for Suicide, Self-Harm, Substance Use, and Psychiatric Disorders in Adults With Inflammatory Bowel Disease: A Nationwide Study in the United States From 2007 to 2017
- 7,440 View
- 95 Download
- 32 Web of Science
- 32 Crossref
- A wide variation of the quality of colonoscopy reporting system in the real clinical practice in southeastern area of Korea
- Jung Min Lee, Yu Jin Kang, Eun Soo Kim, Yoo Jin Lee, Kyung Sik Park, Kwang Bum Cho, Seong Woo Jeon, Min Kyu Jung, Hyun Seok Lee, Eun Young Kim, Jin Tae Jung, Byung Ik Jang, Kyeong Ok Kim, Yun Jin Chung, Chang Hun Yang
- Intest Res 2016;14(4):351-357. Published online October 17, 2016
- DOI: https://doi.org/10.5217/ir.2016.14.4.351
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Abstract
PDFPubReader
<b>Background/Aims</b><br/> Establishment of a colonoscopy reporting system is a prerequisite to determining and improving quality. This study aimed to investigate colonoscopists' opinions and the actual situation of a colonoscopy reporting system in a clinical practice in southeastern area of Korea and to assess the factors predictive of an inadequate reporting system.
Methods Physicians who performed colonoscopies in the Daegu-Gyeongbuk province of Korea and were registered with the Korean Society of Gastrointestinal Endoscopy (KSGE) were interviewed via mail about colonoscopy reporting systems using a standardized questionnaire.
Results Of 181 endoscopists invited to participate, 125 responded to the questionnaires (response rate, 69%). Most responders were internists (105/125, 84%) and worked in primary clinics (88/125, 70.4%). Seventy-one specialists (56.8%) held board certifications for endoscopy from the KSGE. A median of 20 colonoscopies (interquartile range, 10–47) was performed per month. Although 88.8% of responders agreed that a colonoscopy reporting system is necessary, only 18.4% (23/125) had achieved the optimal reporting system level recommended by the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. One-third of endoscopists replied that they did not use a reporting document for the main reasons of "too busy" and "inconvenience." Non-endoscopy specialists and primary care centers were independent predictive factors for failure to use a colonoscopy reporting system.
Conclusions The quality of colonoscopy reporting systems varies widely and is considerably suboptimal in actual clinical practice settings in southeastern Korea, indicating considerable room for quality improvements in this field.
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Citations
Citations to this article as recorded by- Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer
Ki Ju Kim, Hyun Seok Lee, Seong Woo Jeon, Sun Jin, Sang Won Lee
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef - Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef - Screening strategy for colorectal cancer according to risk
Dong Soo Han
Journal of the Korean Medical Association.2017; 60(11): 893. CrossRef
- Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer
- 7,299 View
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- 3 Web of Science
- 3 Crossref
- Quality of care in inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2nd Asian Organization of Crohn's and Colitis (AOCC) meeting in Seoul
- Hye Kyung Song, Kang-Moon Lee, Sung-Ae Jung, Sung Noh Hong, Dong Soo Han, Suk-Kyun Yang
- Intest Res 2016;14(3):240-247. Published online June 27, 2016
- DOI: https://doi.org/10.5217/ir.2016.14.3.240
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> The quality of care in inflammatory bowel disease (IBD) has not been systematically estimated. The aim of this study was to investigate the current status of quality of IBD care in Asian countries.
Methods A questionnaire-based survey was conducted between March 2014 and May 2014. The questionnaire was adopted from "An adult inflammatory bowel disease physician performance measure set" developed by the American Gastroenterological Association. If the respondent executed the performance measure in more than 70% of patients, the measure was regarded as well performed.
Results A total of 353 medical doctors from Asia completed the survey (116 from Korea, 114 from China, 88 from Japan, 17 from Taiwan, 8 from Hong-Kong, 4 from India, 3 from Singapore, and 1 each from the Philippines, Malaysia and Indonesia). The delivery of performance measures, however, varied among countries. The documentation of IBD and tuberculosis screening before anti-tumor necrosis factor therapy were consistently performed well, while pneumococcal immunization and prophylaxis of venous thromboembolisms in hospitalized patients were performed less frequently in all countries. Physician awareness was positively associated with the delivery of performance measures. Variations were also noted in reasons for non-performance or low performance of quality measures, and the two primary reasons cited were consideration of the measure to be unimportant and lack of time.
Conclusions The delivery of performance measures varies among physicians in Asian countries, and reflects variations in the quality of care among the countries. This variation should be recognized to improve the quality of care in Asian countries.
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Eun Mi Song, Soo-Young Na, Sung Noh Hong, Siew Chien Ng, Tadakazu Hisamatsu, Byong Duk Ye
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Review
- Colonoscopy Quality is the Answer for the Emerging Issue of Interval Cancer
- Jae Myung Cha
- Intest Res 2014;12(2):110-116. Published online April 29, 2014
- DOI: https://doi.org/10.5217/ir.2014.12.2.110
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Abstract
PDFPubReader
Colonoscopy is currently regarded as the gold standard and preferred screening method for colorectal cancer (CRC). Recently, however, a limitation of colonoscopy in the prevention of CRCs has been identified, particularly in the right-sided colon, and the problem of so-called interval cancers has emerged. The prevalence of interval cancer is estimated to be between 4% and 8% of CRCs detected. Although the exact etiology of interval cancer remains unknown, factors implicated in the development of interval cancers include missed lesions at the time of colonoscopy, incomplete resection of previous neoplastic lesions, different tumor biology, and serrated pathway of carcinogenesis. However, recent evidence suggests that interval cancers are related to the training of the endoscopist and quality of the colonoscopy rather than tumor biology. Therefore, the importance of adequate training and continuous monitoring of the colonoscopy quality, which are amenable to improvement, cannot be overstated in order to prevent the risk of interval cancers. In this study, the current literature regarding the prevalence and potential factors related to interval cancers and colonoscopy quality-related issues are reviewed.
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