Innovative Care for Inflammatory Bowel Disease Patients during the COVID-19 Pandemic : Use of Bedside Intestinal Ultrasound to Optimize Management
© The Author(s) 2022. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology..
Background: The COVID-19 pandemic caused by SARS-CoV-2 has reduced access to endoscopy and imaging. Safe alternatives, available at the bedside, are needed for accurate, non-invasive strategies to evaluate disease activity. The aim of this study is to establish the impact of clinic-based bedside intestinal ultrasound (IUS) on decision making, reduction in reliance on endoscopy and short-term healthcare utilization.
Methods: We conducted a prospective observational evaluation during the COVID-19 pandemic, of the impact of a regional comprehensive care pathway to manage IBD patients consecutively recruited with acute symptoms, or suspected new diagnosis of IBD. Clinic-based access to sigmoidoscopy and bedside intestinal ultrasound were evaluated, used to direct clinical care and avoid hospitalization or hospital-based endoscopy.
Results: A total of 72 patients were seen between March 15 and June 30, 2020. Of these, 57% (41/72) were female, 64% had Crohn's disease (46/72) with 14% (10/72) presenting with symptoms requiring investigation, of which 5 new cases of IBD were identified (50%). Immediate access to ultrasound and sigmoidoscopy led to meaningful changes in management in 80.5% (58/72) of patients. Active inflammation was detected by IUS alone (72.5%, 29/40) or in combination with in-clinic sigmoidoscopy (78%, 18/23) or sigmoidoscopy alone (78% 7/9). Six patients were referred to colorectal surgery for urgent surgical intervention including two patients admitted directly.
Conclusion: Implementation of IUS as part of a clinical care pathway during the COVID-19 pandemic is a useful strategy to enhance care delivery and improve clinical decisions, while sparing other important acute care resources.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
Journal of the Canadian Association of Gastroenterology - 6(2023), 1 vom: 17. Feb., Seite e1-e6 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lu, Cathy [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 15.02.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/jcag/gwac006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352922184 |
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| 100 | 1 | |a Lu, Cathy |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Innovative Care for Inflammatory Bowel Disease Patients during the COVID-19 Pandemic |b Use of Bedside Intestinal Ultrasound to Optimize Management |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. | ||
| 520 | |a Background: The COVID-19 pandemic caused by SARS-CoV-2 has reduced access to endoscopy and imaging. Safe alternatives, available at the bedside, are needed for accurate, non-invasive strategies to evaluate disease activity. The aim of this study is to establish the impact of clinic-based bedside intestinal ultrasound (IUS) on decision making, reduction in reliance on endoscopy and short-term healthcare utilization | ||
| 520 | |a Methods: We conducted a prospective observational evaluation during the COVID-19 pandemic, of the impact of a regional comprehensive care pathway to manage IBD patients consecutively recruited with acute symptoms, or suspected new diagnosis of IBD. Clinic-based access to sigmoidoscopy and bedside intestinal ultrasound were evaluated, used to direct clinical care and avoid hospitalization or hospital-based endoscopy | ||
| 520 | |a Results: A total of 72 patients were seen between March 15 and June 30, 2020. Of these, 57% (41/72) were female, 64% had Crohn's disease (46/72) with 14% (10/72) presenting with symptoms requiring investigation, of which 5 new cases of IBD were identified (50%). Immediate access to ultrasound and sigmoidoscopy led to meaningful changes in management in 80.5% (58/72) of patients. Active inflammation was detected by IUS alone (72.5%, 29/40) or in combination with in-clinic sigmoidoscopy (78%, 18/23) or sigmoidoscopy alone (78% 7/9). Six patients were referred to colorectal surgery for urgent surgical intervention including two patients admitted directly | ||
| 520 | |a Conclusion: Implementation of IUS as part of a clinical care pathway during the COVID-19 pandemic is a useful strategy to enhance care delivery and improve clinical decisions, while sparing other important acute care resources | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Coronavirus | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a Inflammatory bowel disease | |
| 650 | 4 | |a Ulcerative colitis | |
| 650 | 4 | |a Ultrasound | |
| 700 | 1 | |a Ma, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Ingram, Richard J M |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Melissa |e verfasserin |4 aut | |
| 700 | 1 | |a Kheirkhahrahimabadi, Hengameh |e verfasserin |4 aut | |
| 700 | 1 | |a Martin, Marie-Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Seow, Cynthia H |e verfasserin |4 aut | |
| 700 | 1 | |a Kaplan, Gilaad G |e verfasserin |4 aut | |
| 700 | 1 | |a Heatherington, Joan |e verfasserin |4 aut | |
| 700 | 1 | |a Devlin, Shane M |e verfasserin |4 aut | |
| 700 | 1 | |a Panaccione, Remo |e verfasserin |4 aut | |
| 700 | 1 | |a Novak, Kerri L |e verfasserin |4 aut | |
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