What Are the Most Challenging Aspects of Inflammatory Bowel Disease? An International Survey of Gastroenterologists Comparing Developed and Developing Countries.

Q2 Medicine
Inflammatory Intestinal Diseases Pub Date : 2021-05-01 Epub Date: 2021-02-05 DOI:10.1159/000512310
Richard B Gearry, Andrew M McCombie, Morten Vatn, David T Rubin, Flavio Steinwurz, Edward V Loftus, Wolfgang Kruis, Curt Tysk, Jean-Frederic Colombel, Siew C Ng, Gert Van Assche, Charles N Bernstein
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引用次数: 5

Abstract

Background and aims: As inflammatory bowel disease (IBD) becomes more prevalent, the challenges that gastroenterologists face in managing these patients evolve. We aimed to describe the most important challenges facing gastroenterologists from around the world and compare these between those working in developed and developing countries.

Methods: An online questionnaire was developed, and a link distributed to gastroenterologists. Data were analyzed descriptively using Friedman and Wilcoxon matched-pair signed rank tests to compare rankings for responses. Mann-Whitney U tests were used to compare rankings between responses from gastroenterologists from developed and developing countries. Lower scores reflected greater challenges.

Results: Of 872 who started, 397 gastroenterologists (45.5%) completed the survey. Respondents represented 65 countries (226 [56.9%] from developed countries). Overall, the challenge ranked most important (smallest number) was increasing IBD prevalence (13.6%). There were significant differences in mean ranking scores for many simple aspects of care for those from developing countries compared to providers from developed countries, such as access to simple IBD treatments (5.52 vs. 6.02, p = 0.01), access to anti-TNF drugs including dose escalation (3.33 vs. 3.93, p < 0.01), access to good stoma care (2.57 vs. 3.03, p < 0.001), access to therapeutic drug monitoring (1.47 vs. 1.84, p < 0.001), and access to care for people from low socioeconomic status (2.77 vs. 3.37, p < 0.001).

Conclusions: Increasing IBD prevalence is seen by gastroenterologists as the greatest challenge facing them. There are significant differences between the IBD challenges facing gastroenterologists from developed and developing countries that reflect inequities in access to health care.

炎性肠病最具挑战性的方面是什么?一项比较发达国家和发展中国家胃肠病学家的国际调查。
背景和目的:随着炎症性肠病(IBD)变得越来越普遍,胃肠病学家在管理这些患者时面临的挑战也在不断发展。我们的目的是描述来自世界各地的胃肠病学家面临的最重要的挑战,并比较那些在发达国家和发展中国家工作的人。方法:开发了一份在线问卷,并将链接分发给胃肠病学家。使用Friedman和Wilcoxon配对对签名秩检验对数据进行描述性分析,以比较回答的排名。曼-惠特尼U测试用于比较发达国家和发展中国家胃肠病学家的回答排名。较低的分数反映了更大的挑战。结果:在872名开始调查的人中,397名胃肠病学家(45.5%)完成了调查。受访者来自65个国家(226个[56.9%]来自发达国家)。总体而言,最重要的挑战(人数最少)是IBD患病率上升(13.6%)。与发达国家相比,发展中国家的医护人员在许多简单护理方面的平均排名得分存在显著差异,例如获得简单IBD治疗(5.52比6.02,p = 0.01),获得抗tnf药物(包括剂量递增)(3.33比3.93,p < 0.01),获得良好的口腔护理(2.57比3.03,p < 0.001),获得治疗药物监测(1.47比1.84,p < 0.001),社会经济地位低的人获得护理的机会(2.77 vs. 3.37, p < 0.001)。结论:胃肠病学家认为IBD患病率的增加是他们面临的最大挑战。发达国家和发展中国家的胃肠病学家面临的IBD挑战存在显著差异,这反映了在获得医疗保健方面的不平等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Inflammatory Intestinal Diseases
Inflammatory Intestinal Diseases Medicine-Gastroenterology
CiteScore
4.50
自引率
0.00%
发文量
6
审稿时长
20 weeks
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