The management of iron deficiency in inflammatory bowel disease--an online tool developed by the RAND/UCLA appropriateness method.

Détails

Ressource 1Télécharger: BIB_0D806F13310B.P001.pdf (566.73 [Ko])
Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_0D806F13310B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The management of iron deficiency in inflammatory bowel disease--an online tool developed by the RAND/UCLA appropriateness method.
Périodique
Alimentary Pharmacology and Therapeutics
Auteur(s)
Reinisch W., Chowers Y., Danese S., Dignass A., Gomollón F., Nielsen O.H., Lakatos P.L., Lees C.W., Lindgren S., Lukas M., Mantzaris G.J., Michetti P., Moum B., Peyrin-Biroulet L., Toruner M., van der Woude J., Weiss G., Stoevelaar H.
ISSN
1365-2036 (Electronic)
ISSN-L
0269-2813
Statut éditorial
Publié
Date de publication
2013
Volume
38
Numéro
9
Pages
1109-1118
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish. pdf type: Original Article
Résumé
BACKGROUND: Iron deficiency is a common and undertreated problem in inflammatory bowel disease (IBD).
AIM: To develop an online tool to support treatment choice at the patient-specific level.
METHODS: Using the RAND/UCLA Appropriateness Method (RUAM), a European expert panel assessed the appropriateness of treatment regimens for a variety of clinical scenarios in patients with non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA). Treatment options included adjustment of IBD medication only, oral iron supplementation, high-/low-dose intravenous (IV) regimens, IV iron plus erythropoietin-stimulating agent (ESA), and blood transfusion. The panel process consisted of two individual rating rounds (1148 treatment indications; 9-point scale) and three plenary discussion meetings.
RESULTS: The panel reached agreement on 71% of treatment indications. 'No treatment' was never considered appropriate, and repeat treatment after previous failure was generally discouraged. For 98% of scenarios, at least one treatment was appropriate. Adjustment of IBD medication was deemed appropriate in all patients with active disease. Use of oral iron was mainly considered an option in NAID and mildly anaemic patients without disease activity. IV regimens were often judged appropriate, with high-dose IV iron being the preferred option in 77% of IDA scenarios. Blood transfusion and IV+ESA were indicated in exceptional cases only.
CONCLUSIONS: The RUAM revealed high agreement amongst experts on the management of iron deficiency in patients with IBD. High-dose IV iron was more often considered appropriate than other options. To facilitate dissemination of the recommendations, panel outcomes were embedded in an online tool, accessible via http://ferroscope.com/.
Pubmed
Web of science
Création de la notice
17/11/2013 16:38
Dernière modification de la notice
03/03/2018 13:40
Données d'usage