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Intestinal Research 2009;7(1):41-46.
Published online June 30, 2009.
Inter-Physician Variation in Treatment for Patients with Crohn's Disease
Hwang Choi, Sang Woo Kim, Kang Moon Lee, Bo In Lee, Dae Young Cheung, Min Kuk Kim, Hyun Jung Jung, Hyung Keun Kim, Jeong Seon Ji, Soo Heon Park, Hiun Suk Chae, Myung Gyu Choi, Kyu Yong Choi, In Sik Chung
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
크론병 환자에서 의사별 치료 행태의 차이
최황, 김상우, 이강문, 이보인, 정대영, 김민국, 정현정, 김형근, 지정선, 박수헌, 채현석, 최명규, 최규용, 정인식
가톨릭대학교 의과대학 내과학교실
The incidence and prevalence of Crohn's disease are increasing in Korea. However, the guidelines for the management of Crohn's disease have not been established in Korea. In the current study we determined the difference in the treatment methods between physicians in Korea for Crohn's disease. Methods: We retrospectively analyzed the use of medical and surgical treatment modalities in 92 patients with newly diagnosed Crohn's disease. We compared the treatment strategies among 4 physicians at 3 different institutions. Results: Prednisone, 5-aminosalicylates, antibiotics, immunomodulators, infliximab, and surgery were prescribed or preformed in 64%, 92%, 24%, 35%, 9%, and 22% of the patients, respectively. The surgical procedures included 12 bowel resections and 8 fistulectomies. The prescription rates for 5-aminosalicylates, prednisone, antibiotics, and infliximab did not differ, but of the use of immunomodulators was significantly different between physicians (p=0.012). The mean interval between diagnosis and the start of immunomodulators was 14 months, and was not different between physicians. The median dosage of immunomodulators was 50 mg per day, and was not different between physicians. Conclusions: A difference in medical treatment strategies for Crohn's disease between physicians exists in Korea. Specifically, there was a significant difference in the use of immunodulators between physicians. The development of treatment guidelines for Crohn's disease, together with efforts to decrease the inter-physician difference for treating Crohn's disease are needed. (Intest Res 2009;7:41-46)
Key Words: Crohn Disease, Immunologic Factors, Therapeutics
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