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RISS 인기검색어
- 검색키워드
- 저자 : ( Rupert Wing Loong Leong ) (검색결과 2 건)
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( Silvio Danese ),( Rupa Banerjee ),( Jr Fraser Cummings ),( Iris Dotan ),( Paulo G Kotze ),( Rupert Wing Loong Leong ),( Kristine Paridaens ),( Laurent Peyrin-biroulet ),( Glyn Scott ),( Gert Van Ass 대한장연구학회 2018 Intestinal Research Vol.16 No.4
Symptomatic ulcerative colitis (UC) can be a chronic, disabling condition. Flares in disease activity are associated with many of the negative impacts of mild-to-moderate UC. Rapid resolution of flares can provide benefits to patients and healthcare systems. i Support Therapy-Access to Rapid Treatment (iSTART) introduces patient-centered care for mild-to-moderate UC. iSTART provides patients with the ability to self-assess symptomology and self-start a short course of second-line treatment when necessary. An international panel of experts produced consensus statements and recommendations. These were in formed by evidence from systematic reviews on the epidemiology, mesalazine (5-ASA) treatment, and patient use criteria for second-line therapy in UC. Optimized 5-ASA is the first-line treatment in all clinical guidelines, but may not be sufficient to induce remission in all patients. Corticosteroids should be prescribed as second-line therapy when needed, with budesonide MMX<sup>®</sup> being a preferred steroid option. Active involvement of suitable patients in management of UC flares has the potential to improve therapy, with patients able to show good accuracy for flare self-assessment using validated tools. There is a place in the UC treatment pathway for an approach such as iSTART, which has the potential to provide patient, clinical and economic benefits. (Intest Res 2018;16:522-528)
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Medication non-adherence in inflammatory bowel diseases is associated with disability
( Jonathan Perry ),( Andy Chen ),( Viraj Kariyawasam ),( Glen Collins ),( Chee Choong ),( Wei Ling Teh ),( Nikola Mitrev ),( Friedbert Kohler ),( Rupert Wing Loong Leong ) 대한장연구학회 2018 Intestinal Research Vol.16 No.4
Background/Aims: Medication non-adherence is common in inflammatory bowel diseases (IBD). The short-term conse quences of non-adherence include increased disease relapse but the long-term impact upon patients in terms of daily func tional impairment are less well characterized. Identifying negative outcomes, such as disability, may encourage adherence. Methods: Consecutive ambulatory IBD subjects completed the Medication Adherence Rating Scale (MARS; non-adherence defined as ≤16), Inflammatory Bowel Diseases Disability Index (IBD-DI; disability: <3.5) and Beliefs about Medicines Question naire (high necessity/concerns: ≥16). The primary outcome was the association between medication non-adherence and dis ability. Secondary outcomes were the predictors of these outcomes. Results: A total of 173 subjects on IBD maintenance med ications were recruited (98 Crohn’s disease, 75 ulcerative colitis: median IBD-DI, -5.0; interquartile range [IQR], -14.0 to 4.0 and median MARS, 19.0; IQR, 18 to 20) of whom 24% were non-adherent. Disability correlated significantly with medication non-adherence (r=0.38, P<0.0001). Median IBD-DI for non-adherers was significantly lower than adherers (-16.0 vs. -2.0, P<0.0001). Predictors of disability included female sex (P=0.002), previous hospitalization (P=0.023), management in a referral hospital clinic (P=0.008) and medication concerns (P<0.0001). Non-adherence was independently associated with difficulty managing bowel movements (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.50-9.16, P=0.005), rectal bleeding (OR, 2.69; 95% CI, 1.14-6.36; P=0.024) and arthralgia/arthritis (OR, 2.56; 95% CI, 1.11-5.92; P=0.028). Conclusions: Medication non-adherence was associated with significantly increased disability in IBD. Female gender, higher disease severity and medication concerns were additional predictors of disability. (Intest Res 2018;16:571-578)
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