Dataset Information

Management of Crohn's disease - are guidelines transferred to clinical practice?

ABSTRACT:

Background

Management of Crohn's disease (CD) is a clinical challenge. In terms of an evidence-based approach, clinical guidelines help to deal with this challenge. However, little is known about guideline adherence concerning the management of CD in Germany.

Objective

To survey German gastroenterologists with regards to their guideline adherence in daily clinical care.

Method

A web-based national survey was conducted among German gastroenterologists.

Results

A total of 175 inflammatory bowel disease (IBD) practitioners responded to the survey. Overall, in the different clinical situations covered in the questionnaire guideline adherence is good. However, the 5-aminosalicylic acid (5-ASA) prescribing habits represent a striking exception. About 10-36% use 5-ASA as mono-therapy in CD, depending on the clinical scenario. Predominantly it is used in mild CD and in colonic involvement. To maintain a surgically achieved remission, therapeutic decisions broadly rely on individual approaches with azathioprine and 5-ASA being used by about 30% of the respondents. Cessation of smoking as a "therapeutic" strategy of maintenance therapy is used by only half of the surveyed physicians.

Conclusion

Amongst German IBD practitioners, the guideline adherence is good overall. Reflecting ongoing uncertainty about the efficacy of mesalazine, its use in Crohn's disease is still heterogeneous.

SUBMITTER: Klag T

PROVIDER: S-EPMC4528212 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Management of Crohn's disease - are guidelines transferred to clinical practice?

Klag Thomas T Stange Eduard F EF Wehkamp Jan J

United European gastroenterology journal 20150801 4

<h4>Background</h4>Management of Crohn's disease (CD) is a clinical challenge. In terms of an evidence-based approach, clinical guidelines help to deal with this challenge. However, little is known about guideline adherence concerning the management of CD in Germany.<h4>Objective</h4>To survey German gastroenterologists with regards to their guideline adherence in daily clinical care.<h4>Method</h4>A web-based national survey was conducted among German gastroenterologists.<h4>Results</h4>A total ...[more]

PMID: 26279846

Similar Datasets

Project description:Background & aimsWe aim to provide guidance for medical treatment of luminal Crohn's disease in children.MethodsWe performed a systematic search of publication databases to identify studies of medical management of pediatric Crohn's disease. Quality of evidence and strength of recommendations were rated according to the GRADE (Grading of Recommendation Assessment, Development, and Evaluation) approach. We developed statements through an iterative online platform and then finalized and voted on them.ResultsThe consensus includes 25 statements focused on medical treatment options. Consensus was not reached, and no recommendations were made, for 14 additional statements, largely due to lack of evidence. The group suggested corticosteroid therapies (including budesonide for mild to moderate disease). The group suggested exclusive enteral nutrition for induction therapy and biologic tumor necrosis factor antagonists for induction and maintenance therapy at diagnosis or at early stages of severe disease, and for patients failed by steroid and immunosuppressant induction therapies. The group recommended against the use of oral 5-aminosalicylate for induction or maintenance therapy in patients with moderate disease, and recommended against thiopurines for induction therapy, corticosteroids for maintenance therapy, and cannabis in any role. The group was unable to clearly define the role of concomitant immunosuppressants during initiation therapy with a biologic agent, although thiopurine combinations are not recommended for male patients. No consensus was reached on the role of aminosalicylates in treatment of patients with mild disease, antibiotics or vedolizumab for induction or maintenance therapy, or methotrexate for induction therapy. Patients in clinical remission who are receiving immunomodulators should be assessed for mucosal healing within 1 year of treatment initiation.ConclusionsEvidence-based medical treatment of Crohn's disease in children is recommended, with thorough ongoing assessments to define treatment success.

Dataset Information

Management of Crohn's disease - are guidelines transferred to clinical practice?

Background

Objective

Method

Results

Conclusion

Publications

Management of Crohn's disease - are guidelines transferred to clinical practice?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets