Health Outcomes of American and Canadian IBD Patients

At the American College of Gastroenterology’s 78th Annual Scientific Meeting in San Diego, two separate studies analyzed the health outcomes of inflammatory bowel disease (IBD) in the United States and Canada.

One study focused on care access for patients with IBD, while the second study presented data on the academic achievements of children with IBD compared to those without.

The first study by the Crohn’s and Colitis Foundation of America surveyed 3,802 IBD patients on their access to health care. Of the respondents, 63 percent were working, 17 percent were not working or seeking employment, and 10 percent were unemployed and seeking employment. Sixty-five percent had Crohn’s disease, 32 percent had ulcerative colitis and 3 percent had an indeterminate disease.

A quarter of respondents have no insurance or worse coverage than last year and 59% said it was very difficult to find adequate coverage. Even more said costs were an issue, with 70 percent responding that it was very difficult to afford adequate coverage.

“This national survey identified a significant number of IBD patients with inadequate access to, or difficulties with, their health care,” lead author David T. Rubin, MD, FACG, professor of medicine at the University of Chicago Medicine, said in a statement.

Of the 34 percent of respondents who admitted to ever delaying care because of financial reasons, 25 percent skipped doses of medication, 30 percent took fewer doses, 35 percent delayed filling a prescription, 47 percent delayed an appointment with a physician and 35 percent delayed a scheduled test.

“Twenty-five percent of the nearly 4,000 patients surveyed indicated they had delayed getting medical care in the past year, and of that percent, more than half stated this was due to cost of care,” Rubin said. “These numbers, while discouraging, are an important first step to better understand why patients with IBD may not be getting the best treatments possible.”

The second study, using population-based datasets from the University of Manitoba IBD Epidemiology Database, found children with IBD and children without IBD reached similar levels of academic achievement in grade 12.

The educational outcomes were determined among 337 children with IBD and 3,093 matched controls without IBD.

According to the study, children with IBD with lower socio-economic status had lower standardized scores and a lower likelihood of enrollment in grade 12 by age 17. Among children with IBD, diagnosis of mental health problems around the time of IBD diagnosis was also predictive of lower scores.

“This study suggests that, along with higher attention to children with lower socio-economic status, it is important to assess mental health conditions, including depression, panic disorder and substance abuse, around the time of the IBD diagnosis, as that may have a long-term effect on the child,” lead author Harminder Singh, MD, MPH, assistant profession of medicine at the University of Manitoba in Canada, said in a statement.