Effect of distance to specialist care for the diagnosis and disease outcome of inflammatory bowel disease in the Swiss inflammatory bowel disease cohort study.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_7FE7661AE08D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of distance to specialist care for the diagnosis and disease outcome of inflammatory bowel disease in the Swiss inflammatory bowel disease cohort study.
Journal
Therapeutic advances in gastroenterology
Author(s)
Grob L., Bluemel S., Biedermann L., Fournier N., Rossel J.B., Vavricka S.R., Zeitz J., Rogler G., Stallmach A., Scharl M.
ISSN
1756-283X (Print)
ISSN-L
1756-283X
Publication state
Published
Issued date
2020
Peer-reviewed
Oui
Volume
13
Pages
1756284819895217
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Inflammatory bowel disease (IBD) needs early interventions and an individual specialist-patient relationship. Distance from a tertiary IBD center might affect patient's disease course and outcome. We investigated whether the patient-to-specialist distance has an impact on the disease course using the well-defined patient collective of the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS).
Patient's home address at diagnosis (postal zip code) was extracted from the SIBDCS database. Distance between each zip code and the nearest located IBD specialist center was calculated and classified into the following three sections based on proximity: <10 km (group 1); 10-35 km (group 2); >35 km (group 3).
Our study included in total 408 IBD patients [234 Crohn's disease (CD), 154 ulcerative colitis (UC), 20 IBD unclassified (IBDU)]. Median age was lowest in group 2 at diagnosis (G1: 28 years; G2: 21 years, G3: 26 years, p < 0.01). The diagnostic delay did not differ between groups. CD patients in group 1 were treated more often with anti-tumor necrosis factor (TNF) agents (72% versus 56%, p = 0.04) and 5-aminosalicylates (44% versus 28%, p = 0.04) than in group 3. UC/IBDU patients in group 1 were treated more often with corticosteroids than patients in group 3 (83% versus 58%, p < 0.01). The occurrence of IBD-related surgeries did not differ between groups.
Patient-to-specialist distance might affect drug treatment. However, disease course and the need for IBD-related surgery does not seem to be associated with a longer distance to specialist care in Switzerland.
Keywords
diagnostic delay, disease outcome, tertiary care
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2020 16:33
Last modification date
09/08/2024 15:01
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